Southwest Orofacial Group, INC.
Dentist, Oral and Maxillofacial Surgery in Mesa, AZ. Organization (NPI-2).
NPI number1619707049
StatusActive
Last updated in NPPESMar 4, 2026
Details
- NPI
- 1619707049
- Entity type
- Organization (NPI-2)
- Legal business name
- Southwest Orofacial Group, INC.
- Organization subpart
- No
- Enumeration date
- Aug 1, 2024
- Certification date
- Mar 4, 2026
- Last updated
- Mar 4, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | – | – | Yes |
| 332BC3200X | Durable Medical Equipment & Medical Supplies, Customized Equipment | – | – | |
| 1223X2210X | Dentist, Orofacial Pain | – | – | |
| 122300000X | Dentist | – | – |
Practice location
6116 E Arbor Ave Ste 110Mesa, AZ 85206-6103
Phone 602-992-1486 · Fax 602-992-6604
Mailing address
10214 N Tatum Blvd Ste A1100Phoenix, AZ 85028-4243
Phone 602-992-1486 · Fax 602-992-6604
Authorized official
Therese Garvey
Owner
6029921486
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