Organization
SOUTH CENTRAL DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN CHURCH DMD (DENTIST)
(480) 206-0139
Entity
Organization
Contact information
Practice address
6831 S CENTRAL AVE, PHOENIX, AZ 85042-5420
(602) 268-8881
(602) 243-9826
Mailing address
6831 S CENTRAL AVE, PHOENIX, AZ 85042-5420
(602) 268-8881
(602) 243-9826
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7892
AZ
Other
Enumeration date
10/15/2009
Last updated
10/15/2009
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