Provider Demographics
NPI:1922787654
Name:ARCADIA AZ DENTISTRY
Entity Type:Organization
Organization Name:ARCADIA AZ DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONA MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LETICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROJAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-363-2145
Mailing Address - Street 1:3409 N 56TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-6150
Mailing Address - Country:US
Mailing Address - Phone:480-363-2145
Mailing Address - Fax:480-994-9439
Practice Address - Street 1:3409 N 56TH ST STE A
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-6150
Practice Address - Country:US
Practice Address - Phone:480-994-5557
Practice Address - Fax:480-994-9439
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRIVADENTAL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-11
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty