Provider Demographics
NPI:1093967945
Name:SYNERGY DENTAL GROUP, PLC
Entity Type:Organization
Organization Name:SYNERGY DENTAL GROUP, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-830-2956
Mailing Address - Street 1:3549 E BROWN RD
Mailing Address - Street 2:SUITE #104
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85213-5508
Mailing Address - Country:US
Mailing Address - Phone:480-830-2956
Mailing Address - Fax:480-830-3019
Practice Address - Street 1:3549 E BROWN RD STE 104
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85213-5508
Practice Address - Country:US
Practice Address - Phone:480-830-2956
Practice Address - Fax:480-830-3019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty