| Mirror Image Dental Llc | |
|
4710 E Cactus Rd Phoenix AZ 85032-7706 | |
| (480) 442-0225 | |
| Not Available |
| Full Name | Mirror Image Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4710 E Cactus Rd, Phoenix, Arizona |
| Authorized Official Name and Position | Shawn Michael Maule (CEO / OWNER DENTIST) |
| Authorized Official Contact | 6027059168 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mirror Image Dental Llc 1601 E Potter Dr Phoenix AZ 85024-4334 Ph: (602) 705-9168 | Mirror Image Dental Llc 4710 E Cactus Rd Phoenix AZ 85032-7706 Ph: (480) 442-0225 |
| NPI Number | 1891594016 |
|---|---|
| Provider Enumeration Date | 03/11/2025 |
| Last Update Date | 03/11/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891594016 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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