Provider Demographics
NPI:1609441260
Name:DESERT VALLEY DENTISTRY
Entity Type:Organization
Organization Name:DESERT VALLEY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BENJAMIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:970-644-1175
Mailing Address - Street 1:20280 N 59TH AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-6846
Mailing Address - Country:US
Mailing Address - Phone:480-448-0888
Mailing Address - Fax:
Practice Address - Street 1:20280 N 59TH AVE STE 104
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-6846
Practice Address - Country:US
Practice Address - Phone:480-448-0888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental