# PHOENIX MAXILLOFACIAL TRAUMA ASSOCIATES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114355575
- **Authorized official:** NICOLAS PHILIPPE BEBEAU MD, DDS (OWNER)
- **Authorized official phone:** (480) 300-7152

## Contact information

- **Practice address:** 5410 N SCOTTSDALE RD, SUITE B-110, PARADISE VALLEY, AZ 85253-5927
- **Practice address phone:** (480) 300-7152
- **Practice address fax:** (480) 725-0228
- **Mailing address:** 5410 N SCOTTSDALE RD, SUITE B-110, PARADISE VALLEY, AZ 85253-5927
- **Mailing address phone:** (480) 300-7152
- **Mailing address fax:** (480) 725-0228

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | 47593 | AZ | Yes |

## Other

- **Enumeration date:** 10/23/2013
- **Last updated:** 10/23/2013