Organization
AZ DENTIST LLC
Active
Other names
MODERN FAMILY DENTISTRY
Organization subpart
No
Provider details
NPI number
Authorized official
JANNE MARJORIE LYNCH (OWNER)
(480) 279-3700
Entity
Organization
Contact information
Practice address
7200 W BELL RD STE C3, GLENDALE, AZ 85308-8530
(162) 397-9190
Mailing address
7200 W BELL RD STE C3, GLENDALE, AZ 85308-8530
(623) 979-1900
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
09/13/2023
Last updated
09/21/2023
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