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General NPI Number Information
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NPI Number | 1508730524
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Entity Type | Organization
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Legal Business Name | FOUR PEAKS ENDODONTICS, LLC
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Dates
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Enumeration Date | 10/02/2025
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 6930 E CHAUNCEY LN STE 110
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City | PHOENIX
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State | AZ
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Zip | 85054-5175
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Country | US
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Telephone | 480-630-0000
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Fax | 480-452-1699
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Provider Business Mailing Address
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Address Line | 6930 E CHAUNCEY LN STE 110
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City | PHOENIX
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State | AZ
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Zip | 85054-5175
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Country | US
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Telephone | 480-630-0000
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Fax | 480-452-1699
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | CRISTIN HEGLE
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Credential |
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Telephone | 623-341-1915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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