Organization
ENHOUSE DENTAL LLC
Active
Other names
Dental on Central Tatum Point
Organization subpart
No
Provider details
NPI number
Authorized official
MISS HOLLY MARIE KOZERSKI (PRACTICE ADMINISTRATOR)
(602) 266-1776
Entity
Organization
Contact information
Practice address
4747 E BELL RD, SUITE 7, PHOENIX, AZ 85032-2301
(602) 507-6155
(602) 507-6155
Mailing address
5133 N CENTRAL AVE, SUITE 200, PHOENIX, AZ 85012-1438
(602) 507-6155
(602) 507-6156
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D6700
AZ
Other
Enumeration date
06/03/2015
Last updated
06/03/2015
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