Provider Demographics
NPI:1740007046
Name:ROSE CREST DENTAL PLLC
Entity type:Organization
Organization Name:ROSE CREST DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNSAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-834-5027
Mailing Address - Street 1:1080 E PECOS RD STE 19
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-2426
Mailing Address - Country:US
Mailing Address - Phone:602-834-5027
Mailing Address - Fax:
Practice Address - Street 1:1080 E PECOS RD STE 19
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-2426
Practice Address - Country:US
Practice Address - Phone:602-834-5027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental