Provider Demographics
NPI:1063804813
Name:CYLINDROPUNTIA LLC
Entity type:Organization
Organization Name:CYLINDROPUNTIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:LANPHERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-225-0595
Mailing Address - Street 1:PO BOX 61025
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85082-1025
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3011 S LINDSAY RD
Practice Address - Street 2:SUITE 118
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-4332
Practice Address - Country:US
Practice Address - Phone:480-857-9009
Practice Address - Fax:480-857-9010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-02
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty