COUNTRY CLUB DENTAL MANAGEMENT CO, PC
NPI 1164722021
Dentist in Mesa, AZ

Q: What is Country Club Dental Management Co, PC's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Active since October 26, 2010

4704 E SOUTHERN AVE, SUITE #1, MESA, AZ 85206(480) 889-9457(480) 889-9493 Get Directions Write a Review

NPPES record last updated: October 31, 2013. Verified against the NPPES registry weekly; last sync: September 06, 2026.

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About Country Club Dental Management Co, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COUNTRY CLUB DENTAL MANAGEMENT CO, PC (NPI 1164722021) is a healthcare organization registered as a dentist in Mesa, Arizona and active in the NPI registry since October 2010. The organization lists Lawrence George Groop, Director, as its authorized official.

NPPES Registry Identity

NPI1164722021

Entity TypeOrganization

Primary Taxonomy122300000X

Legal Business NameCOUNTRY CLUB DENTAL MANAGEMENT CO, PC

Location Address4704 E SOUTHERN AVE, SUITE #1Mesa, AZ 85206-2737

Mailing Address4704 E Southern AveMesa, AZ 85206-2737 · (480) 889-9457 · Fax (480) 889-9493

Phone(480) 889-9457

Fax(480) 889-9493

Organization SubpartNo

Authorized OfficialLawrence George GroopDirector · (480) 889-9457

Enumeration DateOctober 26, 2010

Last NPPES UpdateOctober 31, 2013

✔ NPI 1164722021 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in AZ · D07819

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Also ListedDentist · General PracticeTaxonomy 1223G0001X · License D07819 (AZ)

4704 E SOUTHERN AVE, Mesa, AZ 85206

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SUN WEST DENTAL CHANDLER

Clinic/Center (Dental)