Provider Demographics
NPI:1689848277
Name:ABLE DENTAL CARE
Entity Type:Organization
Organization Name:ABLE DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SUSANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVILLAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-275-2020
Mailing Address - Street 1:2229 E MCDOWELL RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2448
Mailing Address - Country:US
Mailing Address - Phone:602-275-2020
Mailing Address - Fax:602-275-0521
Practice Address - Street 1:2229 E MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2448
Practice Address - Country:US
Practice Address - Phone:602-275-2020
Practice Address - Fax:602-275-0521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ4730261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental