Organization · Type 2 NPI

Bismark Lake LLC

Dental Clinic/Center · Goodyear, AZ

NPI number 1285576058 Active

Practice location

14175 W Indian School Rd Ste B6
Goodyear, AZ 85395-8490

Call (602) 902-0275 Map

Mailing address

1786 S 141st Pl
Gilbert, AZ 85295-4752

Specialties and licenses

TaxonomyCodeLicense
Dental Clinic/Center Primary 261QD0000XNone listed

Dental Clinic/Center: Definition to come...

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About NPI 1285576058

Bismark Lake LLC's National Provider Identifier is 1285576058, issued on Apr 8, 2026. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Goodyear, AZ. The record was last updated on Apr 8, 2026.