El Mirage Dentistry
Dentist in El Mirage, AZ. Organization (NPI-2).
NPI number1760611552
StatusActive
Last updated in NPPESJul 14, 2009
Details
- NPI
- 1760611552
- Entity type
- Organization (NPI-2)
- Legal business name
- El Mirage Dentistry
- Organization subpart
- No
- Enumeration date
- Jul 14, 2009
- Last updated
- Jul 14, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | D7345 | AZ | Yes |
Other names
- Classical Dentistry (Doing Business As)
Practice location
10111 N El Mirage RdEl Mirage, AZ 85335-3605
Phone 623-582-3909 · Fax 623-582-3902
Mailing address
10111 N El Mirage RdEl Mirage, AZ 85335-3605
Phone 623-582-3909 · Fax 623-582-3902
Authorized official
Fawne E Pryor
Ins Mgr
6235823909
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Dentist providers in El Mirage, AZ
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.