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General NPI Number Information
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NPI Number | 1689756819
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Entity Type | Organization
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Legal Business Name | PLEASANT DENTISTRY PC
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8279 W LAKE PLEASANT PKWY SUITE 110
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City | PEORIA
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State | AZ
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Zip | 85382
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Country | US
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Telephone | 623-878-0120
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Fax | 623-825-6820
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Provider Business Mailing Address
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Address Line | 8279 W LAKE PLEASANT PKWY SUITE 110
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City | PEORIA
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State | AZ
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Zip | 85382
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Country | US
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Telephone | 623-878-0120
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Fax | 623-825-6820
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Authorized Official
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Title or Position | SECRETARY
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Name | MISS LINDA RASKANSKY
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Credential | DMD
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Telephone | 623-878-0120
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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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