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General NPI Number Information
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NPI Number | 1245465020
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Entity Type | Organization
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Legal Business Name | AMAZING DENTISTRY VIRGINIA M. FLAHART, GEN PTR
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Dates
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Enumeration Date | 05/21/2009
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Last Update Date | 05/21/2009
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Provider Practice Location Address
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Address Line | 2058 S DOBSON RD STE 8
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City | MESA
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State | AZ
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Zip | 85202-6455
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Country | US
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Telephone | 480-345-6950
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Fax | 480-345-6953
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Provider Business Mailing Address
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Address Line | 2058 S DOBSON RD STE 8
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City | MESA
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State | AZ
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Zip | 85202-6455
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Country | US
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Telephone | 480-345-6950
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Fax | 480-345-6953
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Authorized Official
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Title or Position | OWNER
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Name | MS. VIRGINIA MARIE FLAHART
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Credential |
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Telephone | 480-345-6950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7575
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License Number State | AZ
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