| Az Sds Ii Llc | |
|
3409 N 56th St Ste C Phoenix AZ 85018-6150 | |
| (480) 748-4264 | |
| Not Available |
| Full Name | Az Sds Ii Llc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 3409 N 56th St Ste C, Phoenix, Arizona |
| Authorized Official Name and Position | Charlotte Dasch (DIRECTOR OF CRED AND PR) |
| Authorized Official Contact | 5046380303 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Az Sds Ii Llc 1610 54th Ave N Ste 205 Nashville TN 37209-1442 Ph: (615) 678-0759 | Az Sds Ii Llc 3409 N 56th St Ste C Phoenix AZ 85018-6150 Ph: (480) 748-4264 |
| NPI Number | 1992547418 |
|---|---|
| Provider Enumeration Date | 06/07/2024 |
| Last Update Date | 06/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992547418 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Secondary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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