Organization
JAMES S TRICHAK DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES S TRICHAK D.D.S. (OWNER)
(602) 938-4373
Entity
Organization
Contact information
Practice address
3850 W GREENWAY RD STE 100, PHOENIX, AZ 85053-3731
(602) 843-0077
(602) 843-6500
Mailing address
16841 N 31ST AVE, 140, PHOENIX, AZ 85053-3012
(602) 938-4373
(602) 843-3911
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3470
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134180763
INDIVIDUAL
AZ
Enumeration date
04/04/2007
Last updated
10/01/2012
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