Organization
PHOENIX DENTAL AND ORTHODONTICS, PLLC
Active
Other names
Rodeo Dental and Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
RAFFY KOUYOUMDJIAN DDS (OWNER)
(817) 529-8151
Entity
Organization
Contact information
Practice address
7710 W LOWER BUCKEYE RD STE 120, PHOENIX, AZ 85043-3439
(817) 529-8151
(817) 928-1681
Mailing address
100 E 15TH ST STE 520, FORT WORTH, TX 76102-6566
(817) 529-8151
(817) 928-1681
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/13/2022
Last updated
09/13/2022
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