Organization
LYDIAN DENTAL QUEEN CREEK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAM D BUCKHANAN (INSURANCE COORDINATOR)
(480) 445-9188
Entity
Organization
Contact information
Practice address
21295 S ELLSWORTH LOOP RD STE 103, QUEEN CREEK, AZ 85142-9867
(480) 445-9188
(480) 526-8177
Mailing address
21295 S ELLSWORTH LOOP RD STE 103, QUEEN CREEK, AZ 85142-9867
(480) 445-9188
(480) 526-8177
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D009270
AZ
Other
Enumeration date
06/19/2018
Last updated
06/19/2018
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