Provider Demographics
NPI:1063684017
Name:SOMER DENTAL PLLC
Entity Type:Organization
Organization Name:SOMER DENTAL PLLC
Other - Org Name:SOMERSET DENTAL II
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MARCUS
Authorized Official - Last Name:CHEI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:623-907-8282
Mailing Address - Street 1:7625 W LOWER BUCKEYE RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85043-3446
Mailing Address - Country:US
Mailing Address - Phone:623-907-8282
Mailing Address - Fax:623-742-9580
Practice Address - Street 1:7625 W LOWER BUCKEYE RD
Practice Address - Street 2:SUITE 130
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85043-3446
Practice Address - Country:US
Practice Address - Phone:623-907-8282
Practice Address - Fax:623-742-9580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5484122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty