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NPI Code Detail

MEDICARE: TRANQUIL DENTAL CARE, PC

MEDICARE: TRANQUIL DENTAL CARE, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry6555AZ

General Provider Information

NPI Number : 1083893275
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRANQUIL DENTAL CARE, PC
Provider Business Mailing Address
First Line : 1440 E MISSOURI AVE
Second Line : STE 270
City : PHOENIX
State : AZ
Zip : 85014-2458
Country : US
Telephone Number : 602-248-7868
Fax Number : 602-265-5946
Provider Business Practice Location Address
First Line : 1440 E MISSOURI AVE
Second Line : STE 270
City : PHOENIX
State : AZ
Zip : 85014-2458
Country : US
Telephone Number : 602-248-7868
Fax Number : 602-265-5946
Authorized Official
Title or Position : OWNER
Name : DR. RICK ERWIN MARTIN
Credential : DDS
Telephone Number : 602-248-7868
Provider Enumeration Date : 10/24/2007
Last Update Date : 10/24/2007

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Directions to “TRANQUIL DENTAL CARE, PC ” Practice Location

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