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Individual

DR. JASON MICHAEL LOOP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S, M.S.

Contact information

Practice address
10621 N 35TH AVE, PHOENIX, AZ 85029-4260
(602) 978-9040
Mailing address
9882 E SAN SALVADOR DR, SCOTTSDALE, AZ 85258-5629
(323) 217-4911

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
57912
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D07697
AZ

Other

Enumeration date
12/18/2008
Last updated
01/29/2013
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