Provider Demographics
NPI:1992362891
Name:LEMON TREE DENTISTRY LLC
Entity Type:Organization
Organization Name:LEMON TREE DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIONA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBESCU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-759-7659
Mailing Address - Street 1:7364 W BANFF LN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4474
Mailing Address - Country:US
Mailing Address - Phone:623-866-8790
Mailing Address - Fax:
Practice Address - Street 1:1985 W HAPPY VALLEY RD STE 115
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-2888
Practice Address - Country:US
Practice Address - Phone:623-759-7659
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-26
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental