Provider Demographics
NPI:1578020202
Name:ENGLISH OAK ASSOCIATES LLC
Entity Type:Organization
Organization Name:ENGLISH OAK ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DERECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMBRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-548-2050
Mailing Address - Street 1:25355 N LAKE PLEASANT PKWY UNIT 103
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-1504
Mailing Address - Country:US
Mailing Address - Phone:623-937-1888
Mailing Address - Fax:623-825-6885
Practice Address - Street 1:25355 N LAKE PLEASANT PKWY UNIT 103
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383-1504
Practice Address - Country:US
Practice Address - Phone:623-937-1888
Practice Address - Fax:623-825-6885
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COOL GREY MANAGEMENT INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty