| Horizon Dental Group Spring Valley | |
|
17301 E Spring Valley Rd Ste C Spring Valley AZ 86333-4263 | |
| (928) 632-9099 | |
| (928) 458-7090 |
| Full Name | Horizon Dental Group Spring Valley |
|---|---|
| Speciality | Dentist |
| Location | 17301 E Spring Valley Rd Ste C, Spring Valley, Arizona |
| Authorized Official Name and Position | Mark Anthony Costes (OWNER) |
| Authorized Official Contact | 9289256522 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Horizon Dental Group Spring Valley 17301 E Spring Valley Rd Ste C Spring Valley AZ 86333-4263 Ph: (928) 632-9099 | Horizon Dental Group Spring Valley 17301 E Spring Valley Rd Ste C Spring Valley AZ 86333-4263 Ph: (928) 632-9099 |
| NPI Number | 1063969046 |
|---|---|
| Provider Enumeration Date | 09/07/2016 |
| Last Update Date | 09/07/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063969046 | NPI | - | NPPES |
| 731456 | Medicaid | AZ | |
| 703042 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D5634 (Arizona) | Primary |