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General NPI Number Information
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NPI Number | 1770087652
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Entity Type | Organization
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Legal Business Name | WE CARE DENTAL LLC
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Dates
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Enumeration Date | 03/23/2018
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Last Update Date | 03/23/2018
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Provider Practice Location Address
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Address Line | 2525 W GREENWAY RD STE 220
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City | PHOENIX
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State | AZ
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Zip | 85023-4295
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Country | US
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Telephone | 602-595-7523
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Fax | 602-595-7586
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Provider Business Mailing Address
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Address Line | 2525 W GREENWAY RD STE 220
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City | PHOENIX
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State | AZ
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Zip | 85023-4295
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Country | US
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Telephone | 602-595-7523
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Fax | 602-595-7586
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Authorized Official
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Title or Position | OWNER
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Name | RADOSTIN ILIEV MLADENOV
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Credential | RDH
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Telephone | 602-595-7523
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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 | H06000
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License Number State | AZ
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