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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

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
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice AZ 3276
Other Identifiers
Issuer State Number