| Buenhombre Dental Pllc | |
|
15581 W Mackenzie Dr Goodyear AZ 85395-7779 | |
| (520) 429-6957 | |
| Not Available |
| Full Name | Buenhombre Dental Pllc |
|---|---|
| Speciality | Dentist |
| Location | 15581 W Mackenzie Dr, Goodyear, Arizona |
| Authorized Official Name and Position | Caleb Grant Goodman (MEMBER/MANAGER) |
| Authorized Official Contact | 5204296957 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Buenhombre Dental Pllc 15581 W Mackenzie Dr Goodyear AZ 85395-7779 Ph: () - | Buenhombre Dental Pllc 15581 W Mackenzie Dr Goodyear AZ 85395-7779 Ph: (520) 429-6957 |
| NPI Number | 1225442213 |
|---|---|
| Provider Enumeration Date | 06/17/2014 |
| Last Update Date | 06/17/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225442213 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D008966 (Arizona) | Primary |
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