| Phoenix Wisdom Teeth, Llc | |
|
17037 N 43rd Ave # A4a Glendale AZ 85308-4026 | |
| (801) 406-8670 | |
| Not Available |
| Full Name | Phoenix Wisdom Teeth, Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 17037 N 43rd Ave # A4a, Glendale, Arizona |
| Authorized Official Name and Position | Ryan Arnold (MANAGING MEMBER) |
| Authorized Official Contact | 8014068670 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Wisdom Teeth, Llc 5513 W 11000 N # 226 Highland UT 84003-8012 Ph: () - | Phoenix Wisdom Teeth, Llc 17037 N 43rd Ave # A4a Glendale AZ 85308-4026 Ph: (801) 406-8670 |
| NPI Number | 1255945366 |
|---|---|
| Provider Enumeration Date | 09/04/2020 |
| Last Update Date | 09/04/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255945366 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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