Provider Demographics
NPI:1285835876
Name:DR PEASE & ASSOCIATES PLLC
Entity Type:Organization
Organization Name:DR PEASE & ASSOCIATES PLLC
Other - Org Name:DR PEASE AND ASSOCIATES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:A
Authorized Official - Last Name:PEASE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:480-832-3335
Mailing Address - Street 1:4830 E MAIN ST
Mailing Address - Street 2:STE 23
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205
Mailing Address - Country:US
Mailing Address - Phone:480-832-3335
Mailing Address - Fax:480-832-4898
Practice Address - Street 1:4830 E MAIN ST
Practice Address - Street 2:STE 23
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205
Practice Address - Country:US
Practice Address - Phone:480-832-3335
Practice Address - Fax:480-832-4898
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR PEASE & ASSOCIATES PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-30
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19321223G0001X
1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty