Provider Demographics
NPI:1558412635
Name:DENTAL DESIGN OF ARCADIA
Entity Type:Organization
Organization Name:DENTAL DESIGN OF ARCADIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MARO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-994-5557
Mailing Address - Street 1:3409 N 56TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-6150
Mailing Address - Country:US
Mailing Address - Phone:480-994-5557
Mailing Address - Fax:480-994-9439
Practice Address - Street 1:3409 N 56TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-6150
Practice Address - Country:US
Practice Address - Phone:480-994-5557
Practice Address - Fax:480-994-9439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ55741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty