Organization
MESA PAVILIONS DENTAL LLC
Active
Other names
Superstition Springs Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN C HARRIS DDS (OWNER)
(480) 320-9352
Entity
Organization
Contact information
Practice address
1545 S POWER RD, 112, MESA, AZ 85206-3736
(480) 355-4131
Mailing address
1545 S POWER RD, 112, MESA, AZ 85206-3736
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D06580
AZ
Other
Enumeration date
03/08/2016
Last updated
03/08/2016
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