Healthcare Provider Details

I. General information

NPI: 1316858160
Provider Name (Legal Business Name): GCFCM PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2026
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7448 E MAIN ST
MESA AZ
85207-8306
US

IV. Provider business mailing address

7448 E MAIN ST
MESA AZ
85207-8306
US

V. Phone/Fax

Practice location:
  • Phone: 480-396-8684
  • Fax: 480-807-5510
Mailing address:
  • Phone: 480-396-8684
  • Fax: 480-807-5510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: PAUL SANDSTROM
Title or Position: OWNER/PRESIDENT
Credential: DMD
Phone: 480-396-8684