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Organization
THUNDERBIRD DENTISTRY
Active
Organization
THUNDERBIRD DENTISTRY
Active
Parent organization
BRIVADENTAL LLC
Other names
AZ Cosmetic & Family Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
BRIVADENTAL LLC
Authorized official
MRS. LETICIA ROJAS (MANAGER)
(623) 931-9221
Entity
Organization
Contact information
Practice address
9160 N 43RD AVE, GLENDALE, AZ 85302-3801
(623) 931-9221
(623) 937-4315
Mailing address
9160 N 43RD AVE, GLENDALE, AZ 85302-3801
(623) 931-9221
(623) 937-4315
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
NULL
1223G0001X
General Practice Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
12/17/2018
Last updated
09/14/2020
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