Organization
VALLEY ORTHODONTIC GROUP/ PEORIA P.L.L.C.
Active
Organization
VALLEY ORTHODONTIC GROUP/ PEORIA P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL J GROB DDS, MS (OWNER/ORTHODONTIST)
(480) 490-7848
Entity
Organization
Contact information
Practice address
25225 N LAKE PLEASANT PKWY STE 1240, PEORIA, AZ 85383-1390
(623) 572-2683
Mailing address
25225 N LAKE PLEASANT PKWY STE 1240, PEORIA, AZ 85383-1390
(623) 572-2683
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DO3317
AZ
Other
Enumeration date
02/12/2018
Last updated
02/12/2018
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