| Avelle Lichfield Ortho Llc | |
|
14140 W Indian School Rd Ste B1 Goodyear AZ 85395-9293 | |
| (480) 712-9595 | |
| Not Available |
| Full Name | Avelle Lichfield Ortho Llc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 14140 W Indian School Rd Ste B1, Goodyear, Arizona |
| Authorized Official Name and Position | Ethan Larson (DOCTOR) |
| Authorized Official Contact | 2532832747 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avelle Lichfield Ortho Llc 4365 E Pecos Rd Ste 136 Gilbert AZ 85295-8053 Ph: (480) 712-9595 | Avelle Lichfield Ortho Llc 14140 W Indian School Rd Ste B1 Goodyear AZ 85395-9293 Ph: (480) 712-9595 |
| NPI Number | 1770307704 |
|---|---|
| Provider Enumeration Date | 11/15/2024 |
| Last Update Date | 11/15/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770307704 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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