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Organization
DENTAL AND BRACES DYSART LLC
Active
Organization
DENTAL AND BRACES DYSART LLC
Active
Other names
DENTAL AND BRACES DYSART LLC SOMOSDENTAL
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH RAMOS (CREDENTIALING)
(602) 726-3221
Entity
Organization
Contact information
Practice address
1450 N DYSART RD STE A7, AVONDALE, AZ 85323-1534
(623) 471-6962
(602) 714-8203
Mailing address
1515 N GILBERT RD STE 107-131, GILBERT, AZ 85234-2318
(602) 907-1501
(602) 714-8203
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
10/09/2020
Last updated
10/09/2020
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