Provider Demographics
NPI:1548284094
Name:ARIZONA DENTAL SPECIALISTS
Entity type:Organization
Organization Name:ARIZONA DENTAL SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS RECIEVABLE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:LUGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-870-1223
Mailing Address - Street 1:7600 N 15TH ST STE 170
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-4305
Mailing Address - Country:US
Mailing Address - Phone:602-870-1238
Mailing Address - Fax:602-997-4951
Practice Address - Street 1:7600 N 15TH ST STE 170
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-4305
Practice Address - Country:US
Practice Address - Phone:602-870-1238
Practice Address - Fax:602-997-4951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
Not Answered1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty