Organization
ANTHEM DENTAL, LLC
Active
Other names
Classical Dentistry of Arizona
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FAWNE E PRYOR (INSURANCE MANAGER)
(480) 619-7023
Entity
Organization
Contact information
Practice address
41111 N DAISY MOUNTAIN DR, SUITE 105, ANTHEM, AZ 85086-4957
(623) 551-5444
(623) 551-2522
Mailing address
41111 N DAISY MOUNTAIN DR, SUITE 105, ANTHEM, AZ 85086-4957
(623) 551-5444
(623) 551-2522
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D5002
AZ
Other
Enumeration date
08/04/2008
Last updated
08/04/2008
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