Provider Demographics
NPI:1609336320
Name:VALLEY OF THE SUN DENTISTRY P.L.L.C.
Entity Type:Organization
Organization Name:VALLEY OF THE SUN DENTISTRY P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:FINK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-942-4260
Mailing Address - Street 1:18205 N 51ST AVE STE 155
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-1493
Mailing Address - Country:US
Mailing Address - Phone:602-942-4260
Mailing Address - Fax:602-993-5630
Practice Address - Street 1:18205 N 51ST AVE STE 155
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-1493
Practice Address - Country:US
Practice Address - Phone:602-942-4260
Practice Address - Fax:902-993-5630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental