Mill Avenue Family Dentistry PC
Dentist, General Practice in Tempe, AZ. Organization (NPI-2).
NPI number1245309640
StatusActive
Last updated in NPPESApr 26, 2012
Details
- NPI
- 1245309640
- Entity type
- Organization (NPI-2)
- Legal business name
- Mill Avenue Family Dentistry PC
- Organization subpart
- No
- Enumeration date
- Nov 7, 2006
- Last updated
- Apr 26, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Other names
- Tempe Smile Design (Doing Business As)
Practice location
1712 E Guadalupe RdSuite 109
Tempe, AZ 85283-3983
Phone 480-829-8200 · Fax 480-967-5252
Mailing address
1712 E Guadalupe RdSuite 109
Tempe, AZ 85283-3983
Phone 480-829-8200 · Fax 480-967-5252
Authorized official
Stacy Tracy
President Co-Owner
4808298200
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