Organization
DESERT ROSE DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAWNE E PRYOR (MGR)
(623) 582-3909
Entity
Organization
Contact information
Practice address
18001 N 79TH AVE, A-8, GLENDALE, AZ 85308-8388
(623) 878-8000
Mailing address
18001 N 79TH AVE, A-8, GLENDALE, AZ 85308-8388
(623) 878-8000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D6249
AZ
Other
Enumeration date
04/15/2009
Last updated
04/15/2009
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