Organization
AZ OMS SPECIALTY DENTAL SERVICES, LLC
Active
Parent organization
AZ OMS SPECIALTY DENTAL BRANDS, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
AZ OMS SPECIALTY DENTAL BRANDS, LLC
Authorized official
CHARLOTTE DASCH (DIRECTOR OF CREDENTIALING & PR)
(504) 638-0303
Entity
Organization
Contact information
Practice address
42104 N VENTURE DR STE 106, PHOENIX, AZ 85086-3823
(623) 551-6556
Mailing address
1610 54TH AVE N STE 205, NASHVILLE, TN 37209-1442
(504) 638-0303
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
07/18/2023
Last updated
08/02/2023
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