| Ofd13, Llc | |
|
2837 W Northern Ave Phoenix AZ 85051-6646 | |
| (602) 622-9653 | |
| Not Available |
| Full Name | Ofd13, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2837 W Northern Ave, Phoenix, Arizona |
| Authorized Official Name and Position | Harry Nicholas Vondrak (MANAGER) |
| Authorized Official Contact | 4022125131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ofd13, Llc Po Box 45856 Omaha NE 68145-0856 Ph: (402) 779-5334 | Ofd13, Llc 2837 W Northern Ave Phoenix AZ 85051-6646 Ph: (602) 622-9653 |
| NPI Number | 1316581481 |
|---|---|
| Provider Enumeration Date | 11/01/2019 |
| Last Update Date | 11/01/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316581481 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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