Provider Demographics
NPI:1497966196
Name:HAPPY VALLEY DENTISTRY, L.L.C.
Entity Type:Organization
Organization Name:HAPPY VALLEY DENTISTRY, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FORBES
Authorized Official - Middle Name:E
Authorized Official - Last Name:MORSE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:623-587-0300
Mailing Address - Street 1:3830 W PINNACLE PEAK RD STE 103
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85310-4006
Mailing Address - Country:US
Mailing Address - Phone:623-587-0300
Mailing Address - Fax:623-587-1125
Practice Address - Street 1:3830 W PINNACLE PEAK RD STE 103
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85310-4006
Practice Address - Country:US
Practice Address - Phone:623-587-0300
Practice Address - Fax:623-587-1125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ59751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty