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Organization

AZ OMS SPECIALTY DENTAL SERVICES, LLC

Active
Parent organization
AZ OMS SPECIALTY DENTAL SERVICES, LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
AZ OMS SPECIALTY DENTAL SERVICES, LLC
Authorized official
CHARLOTTE DASCH (DIRECTOR OF CREDENTIALING AND PR)
(504) 638-0303
Entity
Organization

Contact information

Practice address
10110 IRON BRIDGE RD, CHESTERFIELD, VA 23832-6529
(504) 638-0303
Mailing address
1610 54TH AVE N STE 205, NASHVILLE, TN 37209-1442
(615) 678-0759

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary

Other

Enumeration date
07/14/2023
Last updated
08/02/2023
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