Mahalo Dental Group LLC

NPI #1992197016 in El Mirage, Arizona

Provider Information

NPI Number: 1992197016
Entity Type: Organization
Organization Name: Mahalo Dental Group LLC
Subpart: Yes (part of a larger organization)
Parent Organization: EL MIRAGE DENTAL EXCELLENCE
Primary Specialty: Dentist
Enumeration Date: Feb 26, 2015
Last Updated: Feb 26, 2015

Practice Location

Address: 10111 N EL MIRAGE RD
Address 2: SUITE #4
City: El Mirage
State: Arizona
ZIP Code: 85335-3605
Phone: (623) 882-1540

Authorized Official

Name: DR. DAN NYDEGGER, DDS
Title: OWNER
Phone: (623) 882-1400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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