Provider Demographics
NPI:1861961096
Name:DENTAL PARTNERS LLC
Entity type:Organization
Organization Name:DENTAL PARTNERS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSTIN
Authorized Official - Middle Name:W
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-448-7890
Mailing Address - Street 1:944 S WATSON RD STE 106
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85326-3437
Mailing Address - Country:US
Mailing Address - Phone:623-439-5522
Mailing Address - Fax:623-215-7859
Practice Address - Street 1:944 S WATSON RD STE 106
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85326-3437
Practice Address - Country:US
Practice Address - Phone:623-439-5522
Practice Address - Fax:623-215-7859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-16
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty