Provider Demographics
NPI:1336293877
Name:DM FAMILY DENTISTRY
Entity Type:Organization
Organization Name:DM FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:DILL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:520-426-0404
Mailing Address - Street 1:2028 N TREKELL RD
Mailing Address - Street 2:#107 OR 108
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85222
Mailing Address - Country:US
Mailing Address - Phone:520-426-0404
Mailing Address - Fax:520-426-1438
Practice Address - Street 1:2028 N TREKELL RD
Practice Address - Street 2:#107 OR 108
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85222
Practice Address - Country:US
Practice Address - Phone:520-426-0404
Practice Address - Fax:520-426-1438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD5883122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty