Organization
WILD WEST ORTHODONTICS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE AYOUB DDS (OWNER/DOCTOR)
(623) 536-2040
Entity
Organization
Contact information
Practice address
14122 W MCDOWELL RD STE 200, GOODYEAR, AZ 85395-2505
(623) 536-2040
(623) 536-8555
Mailing address
14122 W MCDOWELL RD STE 200, GOODYEAR, AZ 85395-2505
(623) 536-2040
(623) 536-8555
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0008582
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1215184528
TYPE 1 NPI
AZ
Enumeration date
02/07/2013
Last updated
02/07/2013
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