| 75th Avenue Dentistry, Inc | |
|
7545 W. Bell Rd Suite 105 Peoria AZ 85382-4764 | |
| (623) 412-2461 | |
| (623) 979-7364 |
| Full Name | 75th Avenue Dentistry, Inc |
|---|---|
| Speciality | Dentist |
| Location | 7545 W. Bell Rd, Peoria, Arizona |
| Authorized Official Name and Position | Taroll Ann Graziano (MANAGER) |
| Authorized Official Contact | 6232256555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 75th Avenue Dentistry, Inc 23525 N. 67th Ave Glendale AZ 85310 Ph: (623) 225-6555 | 75th Avenue Dentistry, Inc 7545 W. Bell Rd Suite 105 Peoria AZ 85382-4764 Ph: (623) 412-2461 |
| NPI Number | 1538284971 |
|---|---|
| Provider Enumeration Date | 03/21/2007 |
| Last Update Date | 03/18/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538284971 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D5988 (Arizona) | Secondary |
| 122300000X | Dentist | D6772 (Arizona) | Primary |
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