Provider Demographics
NPI:1083668230
Name:ENDODONTIC SPECIALISTS LTD
Entity Type:Organization
Organization Name:ENDODONTIC SPECIALISTS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:LEES
Authorized Official - Suffix:II
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:480-834-7100
Mailing Address - Street 1:2220 W SOUTHERN AVENUE
Mailing Address - Street 2:SUITE #102
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-4704
Mailing Address - Country:US
Mailing Address - Phone:480-834-7100
Mailing Address - Fax:480-833-3134
Practice Address - Street 1:2220 W SOUTHERN AVENUE
Practice Address - Street 2:SUITE #102
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4704
Practice Address - Country:US
Practice Address - Phone:480-834-7100
Practice Address - Fax:480-833-3134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty