Organization
LAVEEN PEDIATRIC DENTAL PARTNERS, LLP
Active
Other names
Laveen Kid's Dentist and Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC E ELLIS DMD (OWNER DOCTOR)
(602) 883-8649
Entity
Organization
Contact information
Practice address
5235 W. BASELINE RD, STE 187, LAVEEN, AZ 85339
(602) 883-8649
(602) 744-8778
Mailing address
17000 RED HILL AVE, IRVINE, CA 92614-5626
(714) 845-8656
(949) 474-1495
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
05/31/2016
Last updated
06/01/2016
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