Provider Demographics
NPI:1063976488
Name:C AND E DENTAL PROFESSIONALS
Entity type:Organization
Organization Name:C AND E DENTAL PROFESSIONALS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BONNET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-882-0676
Mailing Address - Street 1:13821 N 35TH DR STE 2
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-5541
Mailing Address - Country:US
Mailing Address - Phone:602-547-9007
Mailing Address - Fax:602-547-3438
Practice Address - Street 1:13821 N 35TH DR STE 2
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85053-5541
Practice Address - Country:US
Practice Address - Phone:602-547-9007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-30
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Multi-Specialty