Laveen Modern Dentistry

NPI #1154856177 in Laveen, Arizona

Provider Information

NPI Number: 1154856177
Entity Type: Organization
Organization Name: Laveen Modern Dentistry
Primary Specialty: Dentist
Enumeration Date: Apr 27, 2017
Last Updated: Apr 27, 2017

Practice Location

Address: 5045 W BASELINE RD STE 135
City: Laveen
State: Arizona
ZIP Code: 85339-7394
Phone: (602) 237-0613

Authorized Official

Name: DR. AMANDA GIRARDI, D.M.D.
Title: DENTIST
Phone: (209) 481-2544

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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