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Organization
BERTZ PROFESSIONAL CORPORATION
Active
Organization
BERTZ PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER LUCAS (OFFICE MANAGER)
(480) 945-0663
Entity
Organization
Contact information
Practice address
3501 N SCOTTSDALE RD STE 110, SCOTTSDALE, AZ 85251-5649
(480) 945-0663
(480) 947-3991
Mailing address
3501 N SCOTTSDALE RD STE 110, SCOTTSDALE, AZ 85251-5649
(480) 945-0663
(480) 947-3991
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
12096
AZ
Other
Enumeration date
07/10/2017
Last updated
12/29/2017
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