Healthcare Provider Details
I. General information
NPI: 1811829310
Provider Name (Legal Business Name): SIGNAL BUTTE KIDS DENTISTRY AND ORTHODONTICS 2, LLP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3528 S SIGNAL BUTTE RD STE 101
MESA AZ
85212-4229
US
IV. Provider business mailing address
PO BOX 660041
DALLAS TX
75266-0041
US
V. Phone/Fax
- Phone: 480-447-6724
- Fax: 480-305-0442
- Phone: 714-845-8890
- Fax: 303-952-0892
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RU
GUO
YANG
Title or Position: OWNER
Credential: DMD
Phone: 480-447-6724