Healthcare Provider Details

I. General information

NPI: 1053420968
Provider Name (Legal Business Name): WEE CARE DENTAL P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 E BELL RD SUITE #116
PHOENIX AZ
85022-6639
US

IV. Provider business mailing address

702 E BELL RD SUITE #116
PHOENIX AZ
85022-6639
US

V. Phone/Fax

Practice location:
  • Phone: 602-867-7880
  • Fax:
Mailing address:
  • Phone: 602-867-7880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number3915
License Number StateAZ

VIII. Authorized Official

Name: ERIC (RICK) J MEYERS
Title or Position: PRESIDENT/DENTIST
Credential: DDS
Phone: 602-867-7880