Provider Demographics
NPI:1205949898
Name:ROBERT G MCCALL DDS PC
Entity type:Organization
Organization Name:ROBERT G MCCALL DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:GUTHRIE
Authorized Official - Last Name:MCCALL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:623-584-4600
Mailing Address - Street 1:5223 E HASHKNIFE RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85054
Mailing Address - Country:US
Mailing Address - Phone:480-699-9372
Mailing Address - Fax:
Practice Address - Street 1:13540 CAMINO DEL SOL
Practice Address - Street 2:SUITE 3
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-4435
Practice Address - Country:US
Practice Address - Phone:623-584-4600
Practice Address - Fax:623-546-1094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1499122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1499OtherLICENSE