Cactus Dental, LLC
Clinic/Center, Dental in Peoria, AZ. Organization (NPI-2).
NPI number1578022018
StatusActive
Last updated in NPPESMar 14, 2019
Details
- NPI
- 1578022018
- Entity type
- Organization (NPI-2)
- Legal business name
- Cactus Dental, LLC
- Organization subpart
- No
- Enumeration date
- Mar 14, 2019
- Last updated
- Mar 14, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Practice location
7440 W Cactus Rd Ste A18Peoria, AZ 85381-9534
Phone 623-979-4400 · Fax 623-979-4402
Mailing address
7440 W Cactus Rd Ste A18Peoria, AZ 85381-9534
Phone 623-979-4400 · Fax 623-979-4402
Authorized official
Brett Garrett Hawkins
Dentist/Owner
6023633322
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