# SUNRISE MOUNTAIN ORAL AND MAXILLOFACIAL SURGERY PLLC

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

## Provider details

- **NPI number:** 1447037304
- **Authorized official:** ERICA BECKER DDS (ORAL AND MAXILLOFACIAL SURGEON)
- **Authorized official phone:** (602) 831-2115

## Contact information

- **Practice address:** 20165 N 67TH AVE STE A102, GLENDALE, AZ 85308-7002
- **Practice address phone:** (602) 831-2115
- **Mailing address:** 17620 N 42ND LN, GLENDALE, AZ 85308-2928

## Taxonomy

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

## Other

- **Enumeration date:** 09/13/2023
- **Last updated:** 10/03/2023