Individual
DR. HOLLY BOTSHEKAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
17037 N 43RD AVE SUITE 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
—
408527
AHCCCS
AZ
01
—
860909125
TAX ID
AZ
Enumeration date
04/09/2007
Last updated
11/27/2018
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