Organization
BELL PARK DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY BOTSHEKAN DENTIST (DENTIST)
(602) 896-9688
Entity
Organization
Contact information
Practice address
17037 N 43RD AVE STE A4, GLENDALE, AZ 85308-4026
(602) 896-9688
(602) 896-9633
Mailing address
17037 N 43RD AVE STE A4, GLENDALE, AZ 85308-4026
(602) 896-9688
(602) 896-9633
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4397
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
357980
RAMIN DAMADZADEH AHCCCS
AZ
01
—
408527
HOLLY BOTSHEKAN AHCCCS
AZ
Enumeration date
04/09/2007
Last updated
08/22/2020
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