Mountainside Dental Group, LLC

NPI #1518270248 in Mesa, Arizona

Provider Information

NPI Number: 1518270248
Entity Type: Organization
Organization Name: Mountainside Dental Group, LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Jul 22, 2010
Last Updated: Jul 22, 2010

Practice Location

Address: 6549 E UNIVERSITY DR
Address 2: SUITE B
City: Mesa
State: Arizona
ZIP Code: 85205-7600
Phone: (480) 981-0590

Authorized Official

Name: DARON CLARE
Title: GENERAL MANAGER
Phone: (480) 981-0590

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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