| Sun Life Pediatric Dentistry | |
|
1864 E Florence Blvd Suite1 Casa Grande AZ 85122-5457 | |
| (520) 836-3446 | |
| (520) 836-8807 |
| Full Name | Sun Life Pediatric Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1864 E Florence Blvd, Casa Grande, Arizona |
| Authorized Official Name and Position | Travis J Robinette (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5208363446 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sun Life Pediatric Dentistry Po Box 10097 Casa Grande AZ 85130-0020 Ph: (520) 836-3446 | Sun Life Pediatric Dentistry 1864 E Florence Blvd Suite1 Casa Grande AZ 85122-5457 Ph: (520) 836-3446 |
| NPI Number | 1992166359 |
|---|---|
| Provider Enumeration Date | 03/14/2016 |
| Last Update Date | 08/03/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992166359 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | BL-16-58324 (Arizona) | Primary |
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