Provider Demographics
NPI:1235249020
Name:CALL, BRENT C (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRENT
Middle Name:C
Last Name:CALL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6311 S ROANOKE ST
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85298-5765
Mailing Address - Country:US
Mailing Address - Phone:480-773-3590
Mailing Address - Fax:
Practice Address - Street 1:6328 E BROWN RD STE 101
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-4841
Practice Address - Country:US
Practice Address - Phone:480-325-5700
Practice Address - Fax:480-831-9352
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD65051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice