| Desert Ridge Implant & Oral Surgery Pc | |
|
20950 N Tatum Blvd Ste. 120 Phoenix AZ 85050-4200 | |
| (480) 563-3960 | |
| (480) 563-3965 |
| Full Name | Desert Ridge Implant & Oral Surgery Pc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 20950 N Tatum Blvd, Phoenix, Arizona |
| Authorized Official Name and Position | Matthew A. Defelice (OWNER) |
| Authorized Official Contact | 4805633960 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Desert Ridge Implant & Oral Surgery Pc 20950 N Tatum Blvd Ste. 120 Phoenix AZ 85050-4200 Ph: (480) 563-3960 | Desert Ridge Implant & Oral Surgery Pc 20950 N Tatum Blvd Ste. 120 Phoenix AZ 85050-4200 Ph: (480) 563-3960 |
| NPI Number | 1588960512 |
|---|---|
| Provider Enumeration Date | 02/09/2011 |
| Last Update Date | 04/04/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588960512 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 5196 (Arizona) | Primary |
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