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1629659131
DENTAL DEPOT OF MESA PLLC
MESA, AZ
NPI
1629659131
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Entity Type
Organization
Authorized Contact
GAYLON ZISSA
Director Of Provider Relations
405-945-8941
Organization Subpart ?
No
Primary Taxonomy
261QD0000X Clinic/Center, Dental
Enumeration Date
2021-04-16
Last Update Date
2021-04-16
Business Address
DENTAL DEPOT OF MESA PLLC
2311 W BROADWAY RD
MESA, AZ 85202-1005
Phone number: 480-571-3050
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Mailing Address
DENTAL DEPOT OF MESA PLLC
2828 NW 30TH ST
OKLAHOMA CITY, OK 73112-7404
Phone number: 405-945-8941
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