1801 Southern Vista Dental Care
1801 Southern Vista Dental Care provides Dentist services in Mesa, Arizona. Licensed in Arizona. Registered with an NPI since 2006.
- Licensed in
- AZ
- In the registry since
- 2006
- Specialties on file
- 3
Practice location Address checks out
1801 E Southern Ave Ste 103Mesa, AZ 85204-5258
Phone: (480) 892-9000
Fax: (480) 926-0545
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Dentist (primary) | Taxonomy 122300000X · Licence 6591 (AZ) |
|---|---|
| Dentist | Taxonomy 122300000X · Licence 6283 (AZ) |
| Dentist | Taxonomy 122300000X · Licence 2561 (AZ) |
Record details
| NPI number | 1023102183 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Elwynn Caffall — Direct Owner · (480) 892-9000 |
| Other names | Southern Vista Dental Care |
| NPI enumerated | October 3, 2006 |
| Last updated in NPPES | August 22, 2020 |
| Mailing address | 1801 E Southern Ave, Suite 103, Mesa, AZ 85204-5258 |
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