Organization
OP ORTHODONTICS OF ARIZONA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD HENDRICKS (CREDENTIALING)
(612) 859-0444
Entity
Organization
Contact information
Practice address
5058 E SOUTHERN AVE STE 101, MESA, AZ 85206-2771
(480) 325-7500
Mailing address
5058 E SOUTHERN AVE STE 101, MESA, AZ 85206-2771
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
11/04/2021
Last updated
11/04/2021
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