OrganizationActive
East Valley Implant and Periodontal PLLC
NPI 1457900656 · Periodontics · Mesa, AZ
Provider details
- NPI number
- 1457900656
- Entity type
- Organization
- Primary specialty
- PeriodonticsDental Providers
- Authorized official
- Mike Cole, Vp Insurance Plan Management
Practice location
3048 E Baseline Rd Ste 112
Mesa, AZ 85204-7287
Phone: (480) 376-2848
Mailing address
8952 E Desert Cove Ave # D101
Scottsdale, AZ 85260-6775
Registry dates
- Enumerated
- 2019-09-10
- Last updated
- 2019-09-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.