Organization Name: | VERITAS DENTAL, PLLC |
NPI Number: | 1366811473 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DANIEL PONCE (PEDIATRIC DENTIST) |
Mailing Address: | 23374 W Yuma Rd Suite 102 Buckeye |
State: | AZ US |
Postal Code: | 853263118 |
Phone Number: | 6234449999 |
Fax Number: | 6234446745 |
NPI Enumeration Date: | 09/18/2015 |
NPI Last Update Date: | 09/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | 9153 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |