Provider Demographics
NPI:1427384916
Name:ENKATSU MANAGEMENT
Entity Type:Organization
Organization Name:ENKATSU MANAGEMENT
Other - Org Name:PLEASANT DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MACK
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:480-231-7020
Mailing Address - Street 1:8279 W LAKE PLEASANT PKWY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-7434
Mailing Address - Country:US
Mailing Address - Phone:623-878-0120
Mailing Address - Fax:623-825-6820
Practice Address - Street 1:8279 W LAKE PLEASANT PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-7434
Practice Address - Country:US
Practice Address - Phone:623-878-0120
Practice Address - Fax:623-825-6820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-19
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty