Provider Demographics
NPI:1194200980
Name:HIGHBURY DENTAL MANAGEMENT, LLC
Entity Type:Organization
Organization Name:HIGHBURY DENTAL MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ARANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-841-0902
Mailing Address - Street 1:4425 S MOUNTAIN RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85212
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4425 S MOUNTAIN RD
Practice Address - Street 2:SUITE 109
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85212
Practice Address - Country:US
Practice Address - Phone:602-776-9700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty