Healthcare Provider Details

I. General information

NPI: 1093652075
Provider Name (Legal Business Name): CLMT ENTERPRISES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 E HUNT HWY STE 14
SAN TAN VALLEY AZ
85143-4964
US

IV. Provider business mailing address

270 E HUNT HWY STE 14
SAN TAN VALLEY AZ
85143-4964
US

V. Phone/Fax

Practice location:
  • Phone: 480-888-2271
  • Fax:
Mailing address:
  • Phone: 480-888-2271
  • Fax:

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: LILLIE BOWERS
Title or Position: MANAGER
Credential:
Phone: 928-200-8634