Provider Demographics
NPI:1124230636
Name:FRIENDLY FAMILY DENTAL CARE, LLC
Entity Type:Organization
Organization Name:FRIENDLY FAMILY DENTAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLAIM
Authorized Official - Middle Name:H
Authorized Official - Last Name:FROST
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:623-536-9942
Mailing Address - Street 1:1579 N DYSART ROAD STE F
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85323
Mailing Address - Country:US
Mailing Address - Phone:623-536-9942
Mailing Address - Fax:623-536-7403
Practice Address - Street 1:1579 N DYSART ROAD STE F
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323
Practice Address - Country:US
Practice Address - Phone:623-536-9942
Practice Address - Fax:623-536-7403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty