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Organization
CASA GRANDE ORAL AND MAXILLOFACIAL SURGERY, P.C.
Active
Organization
CASA GRANDE ORAL AND MAXILLOFACIAL SURGERY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY WADE CULL DDS (PRESIDENT)
(520) 876-5227
Entity
Organization
Contact information
Practice address
1876 E SABIN DR STE 6, CASA GRANDE, AZ 85122-6197
(520) 876-5227
(520) 836-2234
Mailing address
1876 E SABIN DR STE 6, CASA GRANDE, AZ 85122-6197
(520) 876-5227
(520) 836-2234
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
7170
AZ
Other
Enumeration date
02/14/2008
Last updated
01/28/2015
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