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Provider Information for 1982780177

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MARK R CHASE DDS

Gender: MALE

Individual NPI: 1982780177

Calendar   Last Updated:  2014-03-14
  Certification Date: 

Details

Name Value
NPI 1982780177
Enumeration Date 2006-10-31
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 6701 WEST UNION HILLS DRIVE #1
GLENDALE, AZ 85308
United States

Phone: 602-843-0010 | Fax: 602-843-5554
View Map External Link
Primary Practice Address 6701 WEST UNION HILLS DRIVE #1
GLENDALE, AZ 85308
United States

Phone: 602-843-0010 | Fax: 602-843-5554
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice AZ 3276