Organization
PARADISE RIDGE FAMILY DENTISTRY LLC
Active
Other names
Paradise Ridge Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
RODNEY CLARK TILLEY (OWNER/GM)
(602) 695-4192
Entity
Organization
Contact information
Practice address
15433 N TATUM BLVD STE 200, PHOENIX, AZ 85032-4228
(602) 755-4691
Mailing address
16627 S LINDSAY RD, GILBERT, AZ 85295-1501
(602) 695-4192
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/21/2024
Last updated
03/21/2024
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