| Az Oms Specialty Dental Services, Llc | |
|
42104 N Venture Dr Ste 106 Phoenix AZ 85086-3823 | |
| (623) 551-6556 | |
| Not Available |
| Full Name | Az Oms Specialty Dental Services, Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 42104 N Venture Dr Ste 106, Phoenix, Arizona |
| Authorized Official Name and Position | Charlotte Dasch (DIRECTOR OF CREDENTIALING & PR) |
| Authorized Official Contact | 5046380303 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Az Oms Specialty Dental Services, Llc 1610 54th Ave N Ste 205 Nashville TN 37209-1442 Ph: (504) 638-0303 | Az Oms Specialty Dental Services, Llc 42104 N Venture Dr Ste 106 Phoenix AZ 85086-3823 Ph: (623) 551-6556 |
| NPI Number | 1144900994 |
|---|---|
| Provider Enumeration Date | 07/18/2023 |
| Last Update Date | 08/02/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144900994 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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