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Organization
DESERT RIDGE PROSTHODONTICS
Active
Organization
DESERT RIDGE PROSTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY A LIBBY D.D.S. (OWNER)
(480) 502-9833
Entity
Organization
Contact information
Practice address
20950 N TATUM BLVD, SUITE 340, PHOENIX, AZ 85050-4200
(480) 502-9833
Mailing address
20950 N TATUM BLVD, SUITE 340, PHOENIX, AZ 85050-4200
(480) 502-9833
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5457
AZ
Other
Enumeration date
10/26/2007
Last updated
10/26/2007
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