Organization
THOMAS S DURISEK, DDS, PC
Active
Other names
Open Wide Dental
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS SCOTT DURISEK DDS (PRESIDENT)
(602) 347-9999
Entity
Organization
Contact information
Practice address
6520 N 7TH AVE, SUITE #1, PHOENIX, AZ 85013-1158
(602) 347-9999
Mailing address
6520 N 7TH AVE, SUITE #1, PHOENIX, AZ 85013-1158
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
4777
AZ
Other
Enumeration date
12/19/2007
Last updated
12/19/2007
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