Organization
AFFILIATED ORAL & MAXILLOFACIAL SURGEONS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES G BODE DMD (ORAL SURGEON)
(602) 938-0880
Entity
Organization
Contact information
Practice address
5750 W THUNDERBIRD, H-850, GLENDALE, AZ 85306
(602) 938-0880
(602) 547-0528
Mailing address
5750 W THUNDERBIRD, H-850, GLENDALE, AZ 85306
(602) 938-0880
(602) 547-0528
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
2579
AZ
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5950
AZ
Other
Enumeration date
08/22/2006
Last updated
08/22/2020
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