Healthcare Provider Details

I. General information

NPI: 1508793233
Provider Name (Legal Business Name): GARRETT PERIODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7505 W DEER VALLEY RD STE 130
PEORIA AZ
85382-2107
US

IV. Provider business mailing address

19733 E CATTLE DR
QUEEN CREEK AZ
85142-3810
US

V. Phone/Fax

Practice location:
  • Phone: 623-572-7505
  • Fax:
Mailing address:
  • Phone: 361-343-6272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PHILLIP GARRETT
Title or Position: DENTIST
Credential:
Phone: 361-343-6273