Provider Demographics
NPI:1841614799
Name:SANTAN DENTAL ASSOCIATES PLC
Entity Type:Organization
Organization Name:SANTAN DENTAL ASSOCIATES PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:WILKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:520-723-3801
Mailing Address - Street 1:1185 N ARIZONA BLVD
Mailing Address - Street 2:
Mailing Address - City:COOLIDGE
Mailing Address - State:AZ
Mailing Address - Zip Code:85128-3203
Mailing Address - Country:US
Mailing Address - Phone:520-723-3801
Mailing Address - Fax:520-723-3801
Practice Address - Street 1:1185 N ARIZONA BLVD
Practice Address - Street 2:
Practice Address - City:COOLIDGE
Practice Address - State:AZ
Practice Address - Zip Code:85128-3203
Practice Address - Country:US
Practice Address - Phone:520-723-3801
Practice Address - Fax:520-723-3801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-13
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD2533122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty