Individual
BRAXTON HIBBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
35004 N NORTH VALLEY PKWY STE 110, PHOENIX, AZ 85086-3255
(623) 879-9503
Mailing address
6611 E MAYO BLVD, PHOENIX, AZ 85054-4507
(928) 607-8386
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D011805
AZ
Other
Enumeration date
05/31/2023
Last updated
05/31/2023
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