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Organization
PHOENIX DENTAL AND ORTHODONTICS, PLLC
Active
Organization
PHOENIX DENTAL AND ORTHODONTICS, PLLC
Active
Other names
Rodeo Dental and Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
RAFFY KOUYOUMDJIAN DDS (OWNER)
(817) 529-8151
Entity
Organization
Contact information
Practice address
7710 W LOWER BUCKEYE RD STE 120, PHOENIX, AZ 85043-3439
(817) 529-8151
(817) 928-1681
Mailing address
100 E 15TH ST STE 520, FORT WORTH, TX 76102-6566
(817) 529-8151
(817) 928-1681
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/13/2022
Last updated
09/13/2022
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