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General NPI Number Information
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NPI Number | 1770856007
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Entity Type | Organization
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Legal Business Name | CASELDINE DENTAL, SURPRISE, PLLC
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Dates
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Enumeration Date | 02/16/2012
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Last Update Date | 02/16/2012
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Provider Practice Location Address
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Address Line | 14239 W BELL RD SUITE 220
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City | SURPRISE
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State | AZ
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Zip | 85374-2469
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Country | US
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Telephone | 623-518-2686
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Fax | 623-518-2875
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Provider Business Mailing Address
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Address Line | 633 N GILBERT RD
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City | MESA
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State | AZ
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Zip | 85203-6629
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Country | US
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Telephone | 480-898-3053
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Fax | 480-656-4864
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT O CASELDINE
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Credential | D,D.S.
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Telephone | 480-898-3053
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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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