Organization
MARKETSIDE STREET DENTAL LLC
Active
Other names
Sun Valley Pediatric Dentistry-Verrado
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY GARCIA (CREDENTIALING LEAD)
(972) 869-3789
Entity
Organization
Contact information
Practice address
20800 W MARKET ST STE 103, BUCKEYE, AZ 85396-8040
(623) 401-9440
Mailing address
PO BOX 734753, DALLAS, TX 75373-4753
(623) 401-9440
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
08/25/2022
Last updated
09/29/2022
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