Organization
AZ SPECIALTY DENTAL SERVICES, LLC
Active
Parent organization
AZ SPECIALTY DENTAL SERVICES, LLC
Other names
Arizona Pediatric Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
AZ SPECIALTY DENTAL SERVICES, LLC
Authorized official
CHARLOTTE DASCH (DIREC OF CRED AND PR)
(504) 638-0303
Entity
Organization
Contact information
Practice address
3011 S LINDSAY RD STE 108, GILBERT, AZ 85295-4333
(480) 917-9339
Mailing address
1610 54TH AVE N STE 205, NASHVILLE, TN 37209-1442
(615) 678-0759
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
05/29/2024
Last updated
05/29/2024
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