Organization
ANGLE ORTHODONTICS LLC
Active
Organization
ANGLE ORTHODONTICS LLC
Active
Parent organization
PHOENIX PEDIATRIC DENTAL LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHOENIX PEDIATRIC DENTAL LLC
Authorized official
LUZ PACHECO (HUMAN RESOURCE)
(602) 242-5741
Entity
Organization
Contact information
Practice address
5400 W NORTHERN AVE, SUITE 201, GLENDALE, AZ 85301-1406
(623) 500-5797
(602) 242-5742
Mailing address
6750 N 19TH AVE, PHOENIX, AZ 85015-1127
(602) 242-5741
(602) 242-5742
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D05236
AZ
Other
Enumeration date
02/17/2015
Last updated
02/17/2015
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