Provider Demographics
NPI:1043906316
Name:SKY DENTAL CHANDLER
Entity type:Organization
Organization Name:SKY DENTAL CHANDLER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MNGR
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:
Authorized Official - Last Name:PELAYO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-895-3252
Mailing Address - Street 1:975 E RIGGS RD STE 8
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-4260
Mailing Address - Country:US
Mailing Address - Phone:480-895-3252
Mailing Address - Fax:480-452-1267
Practice Address - Street 1:975 E RIGGS RD STE 8
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-4260
Practice Address - Country:US
Practice Address - Phone:480-895-3252
Practice Address - Fax:480-452-1267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-11
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental