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General NPI Number Information
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NPI Number | 1538018130
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Entity Type | Organization
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Legal Business Name | CUSTOM DENTURES AND CROWNS PLLC
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Dates
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Enumeration Date | 01/26/2026
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 13540 W CAMINO DEL SOL STE 21
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City | SUN CITY WEST
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State | AZ
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Zip | 85375-4477
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Country | US
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Telephone | 602-585-5955
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Fax | 623-815-7918
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Provider Business Mailing Address
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Address Line | 13540 W CAMINO DEL SOL STE 21
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City | SUN CITY WEST
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State | AZ
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Zip | 85375-4477
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Country | US
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Telephone | 602-585-5955
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Fax | 623-815-7918
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Authorized Official
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Title or Position | OWNER
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Name | MR. ALEX RIABKOV
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Credential | CPD
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Telephone | 602-585-5955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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