| Pda Holdco, Llc | |
|
1457 W Southern Ave Ste 18 Mesa AZ 85202-4853 | |
| (480) 610-2300 | |
| (480) 833-0682 |
| Full Name | Pda Holdco, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1457 W Southern Ave Ste 18, Mesa, Arizona |
| Authorized Official Name and Position | Daniel Morrissey (PRESIDENT) |
| Authorized Official Contact | 6022536600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pda Holdco, Llc 1701 E Thomas Rd Suite #204 Phoenix AZ 85016-7646 Ph: (602) 253-6600 | Pda Holdco, Llc 1457 W Southern Ave Ste 18 Mesa AZ 85202-4853 Ph: (480) 610-2300 |
| NPI Number | 1821369455 |
|---|---|
| Provider Enumeration Date | 01/12/2012 |
| Last Update Date | 02/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821369455 | NPI | - | NPPES |
| 670703 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D5504 (Arizona) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Dr Allan T Nguyen Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 66 S Dobson Rd, Ste # 144, Mesa, AZ 85202 Phone: 480-969-1550 Fax: 480-969-5550 | |
North Stapely Dental Care Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 335 N Stapley Dr, Mesa, AZ 85203 Phone: 480-964-2662 Fax: 480-649-9813 | |
Western Dental Of Arizona, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1161 E Main St, Mesa, AZ 85203 Phone: 480-834-1555 Fax: 480-962-6710 | |
Green 32 Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 N Greenfield Rd Ste 2, Mesa, AZ 85205 Phone: 480-832-5190 Fax: 480-654-9900 | |
1801 Southern Vista Dental Care Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1801 E Southern Ave, Suite 103, Mesa, AZ 85204 Phone: 480-892-9000 Fax: 480-926-0545 | |
Orthodontic Centers Of Az Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1959 S Val Vista Dr, #118, Mesa, AZ 85204 Phone: 480-539-1000 Fax: 480-539-9900 | |
S. Ryan Young, Dmd Cags Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1702 S Val Vista Dr, Suite 101, Mesa, AZ 85204 Phone: 480-668-8200 |