Organization
OFD13, LLC
Active
Other names
One Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HARRY NICHOLAS VONDRAK JR. (MANAGER)
(402) 212-5131
Entity
Organization
Contact information
Practice address
2837 W NORTHERN AVE, PHOENIX, AZ 85051-6646
(602) 622-9653
Mailing address
PO BOX 45856, OMAHA, NE 68145-0856
(402) 779-5334
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/01/2019
Last updated
11/01/2019
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