Organization
GLENDALE MODERN DENTISTRY, LLP
Active
Other names
Glendale Modern Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
MARISSA BROWN DMD (OWNER DOCTOR)
(623) 939-2600
Entity
Organization
Contact information
Practice address
5143 WEST OLIVE AVE, SUITE 140, GLENDALE, AZ 85302
(623) 939-2600
(623) 939-2603
Mailing address
17000 RED HILL AVE, IRVINE, CA 92614-5626
(714) 845-8890
(949) 474-1495
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
03/13/2014
Last updated
03/13/2014
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