# BERTZ PROFESSIONAL CORPORATION

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

## Provider details

- **NPI number:** 1477075653
- **Authorized official:** JENNIFER LUCAS (OFFICE MANAGER)
- **Authorized official phone:** (480) 945-0663

## Contact information

- **Practice address:** 3501 N SCOTTSDALE RD STE 110, SCOTTSDALE, AZ 85251-5649
- **Practice address phone:** (480) 945-0663
- **Practice address fax:** (480) 947-3991
- **Mailing address:** 3501 N SCOTTSDALE RD STE 110, SCOTTSDALE, AZ 85251-5649
- **Mailing address phone:** (480) 945-0663
- **Mailing address fax:** (480) 947-3991

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | 12096 | AZ | Yes |

## Other

- **Enumeration date:** 07/10/2017
- **Last updated:** 12/29/2017