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General NPI Number Information
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NPI Number | 1992362891
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Entity Type | Organization
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Legal Business Name | LEMON TREE DENTISTRY LLC
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Dates
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Enumeration Date | 05/26/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 1985 W HAPPY VALLEY RD STE 115
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City | PHOENIX
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State | AZ
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Zip | 85085-2888
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Country | US
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Telephone | 623-759-7659
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Fax |
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Provider Business Mailing Address
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Address Line | 7364 W BANFF LN
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City | PEORIA
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State | AZ
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Zip | 85381-4474
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Country | US
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Telephone | 623-866-8790
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ERIONA ROBESCU
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Credential |
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Telephone | 623-759-7659
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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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