# ORAL & MAXILLOFACIAL SURGERY OF PHOENIX

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922437920
- **Authorized official:** NICOLAS BEBEAU MD, DDS (MANAGING MANAGER)
- **Authorized official phone:** (480) 745-2430

## Contact information

- **Practice address:** 5410 N SCOTTSDALE RD STE B100, PARADISE VALLEY, AZ 85253-5907
- **Practice address phone:** (480) 745-2430
- **Mailing address:** 5410 N SCOTTSDALE RD STE B100, PARADISE VALLEY, AZ 85253-5907
- **Mailing address phone:** (480) 745-2430

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 8403 | AZ | Yes |

## Other

- **Enumeration date:** 11/11/2013
- **Last updated:** 11/11/2013