Bonanza Square Dentistry Llc

LBN: Bonanza Square Dentistry Llc
Bonanza Square Dentistry Llc is an health care organization with primary practice located at 200 W Frontier St Suite 5, Payson AZ 85541. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Bonanza Square Dentistry Llc can be contacted via phone (928) 472-2500, or through Jenkins, Eldon Dwayne via phone (480) 205-2476.

Contact Information

Primary practice address
200 W Frontier St Suite 5 Payson AZ 85541
Phone: (928) 472-2500
Fax: (928) 472-6699
Website:
Map and Directions
Authorized official contact:
Name: Jenkins, Eldon Dwayne OWNER
Phone: (480) 205-2476

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X D5797 Arizona

Profile Details

NPI number 1104019918
LBN Legal business name Bonanza Square Dentistry Llc
DBA Doing business as
Authorized official Jenkins, Eldon Dwayne OWNER
Entity Organization
Organization subpart 1 No
Enumeration date Aug 24th, 2007
Last updated Aug 24th, 2007 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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