Organization
WEST BELL ROAD DENTAL LLC
Active
Other names
Jason J. Augustine, D.D.S, M.S., P.C
Organization subpart
No
Provider details
NPI number
Authorized official
VICENTA REYES (LEAD OF CREDENTIALING)
(972) 869-3789
Entity
Organization
Contact information
Practice address
4025 W BELL RD STE 4, PHOENIX, AZ 85053-2748
(602) 978-6910
Mailing address
4025 W BELL RD STE 4, PHOENIX, AZ 85053-2748
(602) 978-6910
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
04/05/2022
Last updated
05/02/2023
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