# ANTHEM CENTER FOR ORAL FACIAL SURGERY PC

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

## Provider details

- **NPI number:** 1396000394
- **Authorized official:** DR. BRIAN J DORFMAN DMD, MD (OWNER)
- **Authorized official phone:** (623) 551-6556

## Contact information

- **Practice address:** 42104 N VENTURE DR STE A106, ANTHEM, AZ 85086-3824
- **Practice address phone:** (623) 551-6556
- **Practice address fax:** (623) 551-6557
- **Mailing address:** 42104 N VENTURE DR STE A106, ANTHEM, AZ 85086-3824
- **Mailing address phone:** (623) 551-6556
- **Mailing address fax:** (623) 551-6557

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | D6337 | AZ | Yes |

## Other

- **Enumeration date:** 07/06/2012
- **Last updated:** 07/06/2012