| Age Defying Dentistry, Phoenix | |
|
4022 E Greenway Rd Ste 13 Phoenix AZ 85032-4797 | |
| (602) 595-1115 | |
| Not Available |
| Full Name | Age Defying Dentistry, Phoenix |
|---|---|
| Speciality | Dentist |
| Location | 4022 E Greenway Rd, Phoenix, Arizona |
| Authorized Official Name and Position | David J Velasco (CO-OWNER) |
| Authorized Official Contact | 6025951115 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Age Defying Dentistry, Phoenix 4022 E Greenway Rd Ste 13 Phoenix AZ 85032-4799 Ph: (602) 595-1115 | Age Defying Dentistry, Phoenix 4022 E Greenway Rd Ste 13 Phoenix AZ 85032-4797 Ph: (602) 595-1115 |
| NPI Number | 1174810840 |
|---|---|
| Provider Enumeration Date | 07/01/2011 |
| Last Update Date | 08/02/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174810840 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | AZ3740 (Arizona) | Primary |
| 122300000X | Dentist | AZ4044 (Arizona) | Secondary |
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