Provider Demographics
NPI:1427184837
Name:DESERT SANDS MANAGEMENT, INC
Entity Type:Organization
Organization Name:DESERT SANDS MANAGEMENT, INC
Other - Org Name:DESERT SANDS DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:HELENE
Authorized Official - Last Name:CALEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-993-2960
Mailing Address - Street 1:245 E BELL RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-2353
Mailing Address - Country:US
Mailing Address - Phone:602-993-2960
Mailing Address - Fax:602-993-5461
Practice Address - Street 1:245 E BELL RD
Practice Address - Street 2:SUITE 2
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-2353
Practice Address - Country:US
Practice Address - Phone:602-993-2960
Practice Address - Fax:602-993-5461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty