Provider Demographics
NPI:1750041919
Name:ARIZONA DENTAL HEALTH II, PLLC
Entity type:Organization
Organization Name:ARIZONA DENTAL HEALTH II, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:PICO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-332-8953
Mailing Address - Street 1:2500 S POWER RD STE 105
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-6687
Mailing Address - Country:US
Mailing Address - Phone:480-926-1899
Mailing Address - Fax:
Practice Address - Street 1:2500 S POWER RD STE 105
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-6687
Practice Address - Country:US
Practice Address - Phone:480-926-1899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental