Individual
DR. BRYCE E SLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5400 W NORTHERN AVE STE 202, GLENDALE, AZ 85301-1591
(623) 500-5793
(623) 321-1030
Mailing address
9169 W ALEX AVE, PEORIA, AZ 85382-8344
(435) 773-7175
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
6979
OK
1223G0001X
General Practice Dentistry
Primary
D010940
AZ
Other
Enumeration date
06/29/2017
Last updated
02/20/2025
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