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Organization
AZ MAX SURGEONS PLC
Active
Organization
AZ MAX SURGEONS PLC
Active
Other names
Arizona Maxillofacial Surgeons PC
Organization subpart
No
Provider details
NPI number
Authorized official
JILIAN PORTER (CREDENTIALING COORDINATOR)
(480) 830-5866
Entity
Organization
Contact information
Practice address
6755 E SUPERSTITION SPRINGS BLVD STE 103, MESA, AZ 85206-4375
(480) 830-5866
(480) 807-0606
Mailing address
6755 E SUPERSTITION SPRINGS BLVD STE 103, MESA, AZ 85206-4375
(480) 830-5866
(480) 807-0606
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
12/19/2018
Last updated
07/30/2021
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