Provider Demographics
NPI:1538629431
Name:BILL ARDITO DDS
Entity type:Organization
Organization Name:BILL ARDITO DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:VITO
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ARDITO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:520-761-1600
Mailing Address - Street 1:3411 W CALLE TRES
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85622-5397
Mailing Address - Country:US
Mailing Address - Phone:520-761-1600
Mailing Address - Fax:
Practice Address - Street 1:855 W BELL RD STE 600
Practice Address - Street 2:
Practice Address - City:NOGALES
Practice Address - State:AZ
Practice Address - Zip Code:85621-4579
Practice Address - Country:US
Practice Address - Phone:520-761-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty