Provider Demographics
NPI:1376983510
Name:CHARLES J. GATTI D.D.S. P.C.
Entity Type:Organization
Organization Name:CHARLES J. GATTI D.D.S. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:GATTI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:623-376-6111
Mailing Address - Street 1:7505 W DEER VALLEY RD
Mailing Address - Street 2:SUITE #140
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-2107
Mailing Address - Country:US
Mailing Address - Phone:623-376-6111
Mailing Address - Fax:623-376-6550
Practice Address - Street 1:7505 W DEER VALLEY RD
Practice Address - Street 2:SUITE #140
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-2107
Practice Address - Country:US
Practice Address - Phone:623-376-6111
Practice Address - Fax:623-376-6550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-02
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD-41971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty