Provider Demographics
NPI:1437640513
Name:GN DENTAL PLLC
Entity Type:Organization
Organization Name:GN DENTAL PLLC
Other - Org Name:ARROWHEAD FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:S
Authorized Official - Last Name:HARIRI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:520-499-9151
Mailing Address - Street 1:20948 N 90TH AVE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-6468
Mailing Address - Country:US
Mailing Address - Phone:520-499-9151
Mailing Address - Fax:
Practice Address - Street 1:7777 W DEER VALLEY RD STE 160
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-2104
Practice Address - Country:US
Practice Address - Phone:623-561-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental