Organization
ANTHEM DENTIST
Active
Parent organization
BRIVADENTAL LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BRIVADENTAL LLC
Authorized official
LETICIA ROJAS (REGIONAL MANAGER)
(480) 363-2145
Entity
Organization
Contact information
Practice address
42201 N 41ST DR STE 156, ANTHEM, AZ 85086-3803
(623) 551-3511
(623) 551-3513
Mailing address
42201 N 41ST DR STE 156, ANTHEM, AZ 85086-3803
(623) 551-3511
(623) 551-3513
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/01/2023
Last updated
09/01/2023
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