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Organization
MARYLAND AVENUE PERIODONTICS, LLC
Active
Organization
MARYLAND AVENUE PERIODONTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER WARNER (OFFICE MANAGER)
(602) 242-2588
Entity
Organization
Contact information
Practice address
6520 N 7TH AVE STE 5, PHOENIX, AZ 85013-1158
(602) 242-2588
(602) 242-3137
Mailing address
6520 N 7TH AVE STE 5, PHOENIX, AZ 85013-1158
(602) 242-2588
(602) 242-3137
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
04/26/2011
Last updated
04/26/2011
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