Provider Demographics
NPI:1144607896
Name:PRECIOUS DENTAL SERVICE PLC
Entity Type:Organization
Organization Name:PRECIOUS DENTAL SERVICE PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHAKIRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GUMMADI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:520-466-3920
Mailing Address - Street 1:3260 NORTH TOLTEC ROAD
Mailing Address - Street 2:
Mailing Address - City:ELOY
Mailing Address - State:AZ
Mailing Address - Zip Code:85131
Mailing Address - Country:US
Mailing Address - Phone:520-466-3920
Mailing Address - Fax:520-466-3921
Practice Address - Street 1:3260 NORTH TOLTEC ROAD
Practice Address - Street 2:
Practice Address - City:ELOY
Practice Address - State:AZ
Practice Address - Zip Code:85131
Practice Address - Country:US
Practice Address - Phone:520-466-3920
Practice Address - Fax:520-466-3921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-01
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty