Organization
CENTRAL AVENUE SPECIALTY, PLLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY E HERRO DDS (OWNER)
(602) 266-1776
Entity
Organization
Contact information
Practice address
5133 N CENTRAL AVE, SUITE 200, PHOENIX, AZ 85012-1438
(602) 266-1776
(602) 234-1814
Mailing address
5133 N CENTRAL AVE, SUITE 102, PHOENIX, AZ 85012-1438
(602) 266-1776
(602) 234-1814
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
D07259
AZ
1223P0221X
Pediatric Dentistry
D008035
AZ
1223P0700X
Prosthodontics
D008106
AZ
Other
Enumeration date
12/04/2013
Last updated
12/04/2013
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