Organization · NPI-2

Advanced Dental Concepts PC

Dentist, General Practice · Mesa, AZ

NPI number1194890152
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1194890152
Entity type
Organization (NPI-2)
Legal business name
Advanced Dental Concepts PC
Organization subpart
No
Enumeration date
Nov 22, 2006
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice2398AZAZYes

Practice location

801 S Power Road
Suite 104
Mesa, AZ 85206-5222

Phone 480-807-9559 · Fax 480-807-6876

Mailing address

801 S Power Road
Suite 104
Mesa, AZ 85206-5222

Phone 480-807-9559 · Fax 480-807-6876

Authorized official

Patrick M Smith
President
4808079559

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