NPI 1023102183
1801 Southern Vista Dental Care
Practice location
- Address
- 1801 E Southern Ave Suite 103, Mesa, AZ 85204-5258
- Phone
- (480) 892-9000
- Fax
- (480) 926-0545
Authorised official
- Name
- Elwynn Chad Caffall
- Title
- Direct Owner
- Phone
- (480) 892-9000
Registered specialties (3)
Dentist
Primary
Dentist
Dentist
Registry record
- NPI
- 1023102183
- Entity type
- Organization
- NPI issued
- 3 Oct 2006
- Record last updated
- 22 Aug 2020
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.