Provider Demographics
NPI:1154481026
Name:MOUNTAIN VIEW FAMILY DENTAL PLLC
Entity Type:Organization
Organization Name:MOUNTAIN VIEW FAMILY DENTAL PLLC
Other - Org Name:MOUNTAIN VIEW FAMILY DENTISTRY PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:SHAYNE
Authorized Official - Last Name:GUFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:480-830-0262
Mailing Address - Street 1:2820 E UNIVERSITY DR
Mailing Address - Street 2:STE #108
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85213-8500
Mailing Address - Country:US
Mailing Address - Phone:480-830-0262
Mailing Address - Fax:480-981-8355
Practice Address - Street 1:2820 E UNIVERSITY DR
Practice Address - Street 2:STE #108
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85213-8500
Practice Address - Country:US
Practice Address - Phone:480-830-0262
Practice Address - Fax:480-981-8355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ58461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty