Provider Demographics
NPI:1447728654
Name:STEELE DENTAL GROUP
Entity type:Organization
Organization Name:STEELE DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANDPRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-546-3511
Mailing Address - Street 1:6898 S TUCANA LN
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85298-9062
Mailing Address - Country:US
Mailing Address - Phone:480-268-6707
Mailing Address - Fax:
Practice Address - Street 1:15409 W GREENWAY RD STE 100
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-4368
Practice Address - Country:US
Practice Address - Phone:623-546-3511
Practice Address - Fax:623-546-3061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental