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NPI 1063005049

OrganizationActive

Dental Specialty Group Inc

NPI 1063005049 · Periodontics · Mesa, AZ

Provider details

NPI number: 1063005049
Entity type: Organization
Primary specialty: PeriodonticsDental Providers
Organization subpart: No
Authorized official: Bennett Mankin, President(480) 239-2088

Specialties & taxonomies

PeriodonticsPrimary1223P0300X
Dental Providers
Endodontics1223E0200X
Dental Providers
Oral and Maxillofacial Pathology Dentistry1223P0106X
Dental Providers

Practice location

4435 E Broadway Rd Ste 7

Mesa, AZ 85206-2012

Phone: (480) 471-8480

Fax: (480) 654-0705

Approximate (ZIP-level) locationGet directions

More AZ providers

Mailing address

3658 E Morrison Ranch Pkwy

Gilbert, AZ 85296-1816

Registry dates

Enumerated: 2021-02-19
Last updated: 2021-02-26
Certified: 2021-02-26

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Dental Specialty Group Inc — NPI 1063005049, Mesa, AZ | NPI Central