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General NPI Number Information
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NPI Number | 1215879481
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Entity Type | Organization
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Legal Business Name | CACTUS VALLEY DENTISTRY PLLC
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Dates
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Enumeration Date | 04/07/2026
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Last Update Date | 04/07/2026
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Provider Practice Location Address
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Address Line | 1185 N ARIZONA BLVD
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City | COOLIDGE
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State | AZ
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Zip | 85128-3203
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Country | US
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Telephone | 520-231-9515
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Fax | 520-231-9515
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Provider Business Mailing Address
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Address Line | 22829 E GALVESTON ST
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City | MESA
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State | AZ
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Zip | 85212-8916
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Country | US
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Telephone | 480-307-5000
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | JOSE ANDRES ANDRINO
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Credential | DDS
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Telephone | 480-307-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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