Organization
PURELY DENTAL SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT L WOODMANSEE DMD (MANAGING PARTNER)
(602) 799-2251
Entity
Organization
Contact information
Practice address
12320 N 32ND ST STE 2, PHOENIX, AZ 85032-7154
(602) 354-5356
Mailing address
12320 N 32ND ST STE 2, PHOENIX, AZ 85032-7154
(602) 354-5356
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
04/17/2019
Last updated
04/17/2019
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