Provider Demographics
NPI:1033990023
Name:DENTISTS OF ASANTE LLP
Entity Type:Organization
Organization Name:DENTISTS OF ASANTE LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEELEY
Authorized Official - Middle Name:NGA
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:623-738-0370
Mailing Address - Street 1:PO BOX 920050
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75392-0050
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16350 N PAT TILLMAN BLVD
Practice Address - Street 2:STE 120
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85387
Practice Address - Country:US
Practice Address - Phone:623-738-0370
Practice Address - Fax:623-707-2715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty