Organization
ULTRA DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BOBBY YASSO DMD (DENTIST)
(602) 613-8004
Entity
Organization
Contact information
Practice address
731 E UNION HILLS DR STE B7, PHOENIX, AZ 85024-2910
(602) 613-8004
(602) 613-8009
Mailing address
8612 W MELINDA LN, PEORIA, AZ 85382-2499
(602) 613-8004
(602) 613-8009
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223G0001X
General Practice Dentistry
—
—
Other
Enumeration date
03/22/2023
Last updated
04/11/2023
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