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Organization
ARIZONA DENTAL AFFILIATES, PLLC
Active
Organization
ARIZONA DENTAL AFFILIATES, PLLC
Active
Other names
Wellness Dental Mesa
Organization subpart
No
Provider details
NPI number
Authorized official
SIBERA TROY BRANNON DDS (OWNER)
(520) 376-8538
Entity
Organization
Contact information
Practice address
1157 S CRISMON RD STE 103, MESA, AZ 85208-2661
(520) 376-8538
Mailing address
1157 S CRISMON RD STE 103, MESA, AZ 85208-2661
(520) 376-8538
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/26/2022
Last updated
09/26/2022
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