Organization
HAYDEN LAKE FAMILY DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHASE DAVIS DDS (MEMBER)
(480) 917-8400
Entity
Organization
Contact information
Practice address
8636 N WAYNE DR, HAYDEN, ID 83835-5084
(208) 762-1555
Mailing address
3010 E FRUITVALE AVE, GILBERT, AZ 85297-5261
(480) 341-0095
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/02/2024
Last updated
07/02/2024
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