Maricopa Family Dental LLC

NPI #1831731587 in Maricopa, Arizona

Provider Information

NPI Number: 1831731587
Entity Type: Organization
Organization Name: Maricopa Family Dental LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 15, 2019
Last Updated: Oct 15, 2019

Practice Location

Address: 20046 N. JOHN WAYNE PKWY
Address 2: SUITE 105
City: Maricopa
State: Arizona
ZIP Code: 85139
Phone: (520) 316-6100

Authorized Official

Name: FAITH GASKINS
Title: DIRECTOR OF CREDENTIALING
Phone: (972) 869-3789

Specialties & Taxonomy Codes

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

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