| San Tan Pediatric Dental | |
|
2510 E Hunt Hwy Suite #29 Queen Creek AZ 85243-5206 | |
| (480) 457-1693 | |
| (480) 457-1321 |
| Full Name | San Tan Pediatric Dental |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2510 E Hunt Hwy, Queen Creek, Arizona |
| Authorized Official Name and Position | Stephen J Montoya (OWNER) |
| Authorized Official Contact | 4804571693 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| San Tan Pediatric Dental 2510 E Hunt Hwy Suite #29 Queen Creek AZ 85243-5206 Ph: (480) 457-1693 | San Tan Pediatric Dental 2510 E Hunt Hwy Suite #29 Queen Creek AZ 85243-5206 Ph: (480) 457-1693 |
| NPI Number | 1265625552 |
|---|---|
| Provider Enumeration Date | 08/21/2007 |
| Last Update Date | 10/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265625552 | NPI | - | NPPES |
| 285009 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 7384 (Arizona) | Primary |
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