| Az Sds Iii Llc | |
|
3549 E Brown Rd Ste 102 Mesa AZ 85213-5606 | |
| (480) 634-5686 | |
| Not Available |
| Full Name | Az Sds Iii Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 3549 E Brown Rd Ste 102, Mesa, Arizona |
| Authorized Official Name and Position | Charlotte V Dasch (SR DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 5046380303 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Az Sds Iii Llc 1610 54th Ave N Ste 205 Nashville TN 37209-1442 Ph: (504) 638-0303 | Az Sds Iii Llc 3549 E Brown Rd Ste 102 Mesa AZ 85213-5606 Ph: (480) 634-5686 |
| NPI Number | 1669358347 |
|---|---|
| Provider Enumeration Date | 08/15/2025 |
| Last Update Date | 08/15/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669358347 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Secondary |
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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