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NPI 1376019075

OrganizationActive

East Valley Implant & Periodontal Center

NPI 1376019075 · Periodontics · Mesa, AZ

Provider details

NPI number: 1376019075
Entity type: Organization
Primary specialty: PeriodonticsDental Providers
Authorized official: Brett Lee, Office Manager

Practice location

3048 E Baseline Rd Ste 112

Mesa, AZ 85204-7287

Phone: (480) 558-4504

Fax: (480) 827-9703

More AZ providers

Mailing address

3048 E Baseline Rd Ste 112

Mesa, AZ 85204-7287

Registry dates

Enumerated: 2018-10-19
Last updated: 2018-10-19

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

East Valley Implant & Periodontal Center — NPI 1376019075, Mesa, AZ | NPI Central