Azcdc,llc
Clinic/Center, Dental in Glendale, AZ. Organization (NPI-2).
NPI number1639622103
StatusActive
Last updated in NPPESOct 20, 2016
Details
- NPI
- 1639622103
- Entity type
- Organization (NPI-2)
- Legal business name
- Azcdc,llc
- Organization subpart
- No
- Enumeration date
- Aug 1, 2016
- Last updated
- Oct 20, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | D4274 | AZ | Yes |
| 261QD0000X | Clinic/Center, Dental | DD4407 | NM |
Practice location
5700 W Olive AveGlendale, AZ 85302
Phone 480-226-5652
Mailing address
Pobox 5132Peoria, AZ 85385
Phone 480-226-5652
Authorized official
Joan L Fox
Dentis
4802265652
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