Organization
AZ SDS III LLC
Active
Parent organization
AZ SDS III LLC
Other names
Camelback Pediatric Dentistry and Orthodontics
Organization subpart
Yes
Provider details
NPI number
Legal business name
AZ SDS III LLC
Authorized official
CHARLOTTE DASCH (SR DIRECTOR OF CREDENTIALING)
(504) 638-0303
Entity
Organization
Contact information
Practice address
4901 N 44TH ST STE 101, PHOENIX, AZ 85018-2782
(602) 595-3531
Mailing address
1610 54TH AVE N STE 205, NASHVILLE, TN 37209-1442
(504) 638-0303
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
08/15/2025
Last updated
08/15/2025
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