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Organization

SURPRISE DENTAL, LLC

Active
Other names
West Valley Family Dental
Organization subpart
No

Provider details

NPI number
Authorized official
FAWNE E PRYOR (OFFICE MANAGER)
(623) 582-9622
Entity
Organization

Contact information

Practice address
16630 W GREENWAY RD, SUITE 319, SURPRISE, AZ 85388-2185
(623) 582-9622
Mailing address
16630 W GREENWAY RD, SUITE 319, SURPRISE, AZ 85388-2185
(623) 582-9622

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D5002
AZ

Other

Enumeration date
11/11/2008
Last updated
11/11/2008
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