Organization · Type 2 NPI

Platinum Dental Spa PLLC

Dental Clinic/Center · Peoria, AZ

NPI number 1124549191 Active

Practice location

13660 N 94th Dr Ste B1
Peoria, AZ 85381-4848

Specialties and licenses

Taxonomy	Code	License
Dental Clinic/Center Primary	261QD0000X	None listed

Dental Clinic/Center: Definition to come...

2 other providers at this address

Other dental clinic/center providers in Peoria

See all in Peoria →

NPI record

NPI: 1124549191
Entity type: Organization (Type 2)
Issued: Jun 29, 2017
Last updated: Jul 21, 2022
Status: Active

Other names

<unavail>
Modern Dentistry of Suncity · doing business as
Modern Dentistry of Suncity · doing business as

Authorized official

Dr. Andrea J Botar, DDS
Owner
(623) 977-2551

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1124549191

Platinum Dental Spa PLLC's National Provider Identifier is 1124549191, issued on Jun 29, 2017. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Peoria, AZ. The record was last updated on Jul 21, 2022.