EAST VALLEY IMPLANT & PERIODONTAL CENTER NPI 1376019075

NPI Information

EAST VALLEY IMPLANT & PERIODONTAL CENTER is a periodontics dentist in Mesa, AZ. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. EAST VALLEY IMPLANT & PERIODONTAL CENTER NPI is 1376019075. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3048 E BASELINE RD STE 112
MESA, AZ
ZIP 85204-287
Phone: (480) 558-4504
Fax: (480) 827-9703

The provider's authorized official is Brett E Lee .
The authorized official title is Office Manager and has the following contact phone number (480) 558-4504.

The enumeration date for this NPI number is 10/19/2018 and was last updated on 10/19/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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