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General NPI Number Information
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NPI Number | 1346816535
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Entity Type | Organization
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Legal Business Name | NORTHEAST GILBERT DENTISTRY LLP
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Dates
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Enumeration Date | 05/28/2021
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Last Update Date | 05/28/2021
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Provider Practice Location Address
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Address Line | 5215 E BASELINE RD STE 101
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City | GILBERT
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State | AZ
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Zip | 85234-2499
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Country | US
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Telephone | 480-779-6393
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Fax | 480-977-6111
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Provider Business Mailing Address
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Address Line | PO BOX 920050
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City | DALLAS
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State | TX
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Zip | 75392-0050
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSHUA ARMSTRONG
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Credential | DMD
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Telephone | 480-779-6393
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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 |
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License Number State |
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