Provider Demographics
NPI:1770154866
Name:DOLCE, MIKAYLA QUINN (DMD)
Entity type:Individual
Prefix:
First Name:MIKAYLA
Middle Name:QUINN
Last Name:DOLCE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 W GERMANN RD APT 3014
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-0109
Mailing Address - Country:US
Mailing Address - Phone:480-290-3978
Mailing Address - Fax:
Practice Address - Street 1:1821 N TREKELL RD
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-1705
Practice Address - Country:US
Practice Address - Phone:520-374-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0110981223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health