Organization
MIRROR IMAGE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAWN MICHAEL MAULE DDS (CEO / OWNER DENTIST)
(602) 705-9168
Entity
Organization
Contact information
Practice address
4710 E CACTUS RD, PHOENIX, AZ 85032-7706
(480) 442-0225
Mailing address
1601 E POTTER DR, PHOENIX, AZ 85024-4334
(602) 705-9168
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/11/2025
Last updated
03/11/2025
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