Organization
SURPRISE ENDO PLLC
Active
Other names
Surprise Endodontics
Organization subpart
No
Provider details
NPI number
Authorized official
RYNE JACKSON DMD, MSD (OWNER)
(480) 353-6476
Entity
Organization
Contact information
Practice address
15294 W BROOKSIDE LN STE 100, SURPRISE, AZ 85374-2446
(623) 376-7400
Mailing address
15294 W BROOKSIDE LN STE 100, SURPRISE, AZ 85374-2446
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
03/04/2025
Last updated
03/04/2025
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