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Organization
PEORIA DENTISTRY
Active
Organization
PEORIA DENTISTRY
Active
Parent organization
BRIVADENTAL LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BRIVADENTAL LLC
Authorized official
MRS. LETICIA L ROJAS (REGIONAL MANAGER)
(480) 363-2145
Entity
Organization
Contact information
Practice address
20470 N LAKE PLEASANT RD STE 105, PEORIA, AZ 85382-9708
(623) 825-7003
(623) 825-0076
Mailing address
20470 N LAKE PLEASANT RD STE 105, PEORIA, AZ 85382-9708
(623) 825-7003
(623) 825-0076
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/05/2024
Last updated
08/05/2024
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