Provider Demographics
NPI:1467156406
Name:COMPASS POINT DENTAL PLLC
Entity Type:Organization
Organization Name:COMPASS POINT DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRYCE
Authorized Official - Middle Name:E
Authorized Official - Last Name:SLACK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:623-500-5793
Mailing Address - Street 1:5400 W NORTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85301-1400
Mailing Address - Country:US
Mailing Address - Phone:623-500-5793
Mailing Address - Fax:
Practice Address - Street 1:5400 W NORTHERN AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-1400
Practice Address - Country:US
Practice Address - Phone:623-500-5793
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty