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Organization

CREATIVE BESPOKE AZ

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MATHEW JAMES (PATIENT ACCOUNTS)
(631) 827-8159
Entity
Organization

Contact information

Practice address
4808 E MOONLIGHT WAY, PARADISE VLY, AZ 85253-2926
(631) 827-8159
Mailing address
4808 E MOONLIGHT WAY, PARADISE VLY, AZ 85253-2926
(631) 827-8159

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary

Other

Enumeration date
03/08/2019
Last updated
03/08/2019
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