Organization
CORONADO DENTAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILLIP M HENDRIX JR. D.D.S. (DOCTOR)
(480) 461-8683
Entity
Organization
Contact information
Practice address
610 N ALMA SCHOOL ROAD, SUITE 4, CHANDLER, AZ 85224-3687
(480) 461-8683
(480) 964-4171
Mailing address
610 N ALMA SCHOOL ROAD, SUITE 4, CHANDLER, AZ 85224-3687
(480) 461-8683
(480) 964-4171
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D5032
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
188286
—
AZ
05
—
46654101
—
AZ
05
—
49124101
—
AZ
Enumeration date
11/06/2006
Last updated
01/11/2011
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