Organization
LAVEEN MODERN DENTISTRY, LLP
Active
Other names
Laveen Modern Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN NELSON DMD (OWNER DMD)
(602) 237-0613
Entity
Organization
Contact information
Practice address
5045 W BASELINE RD STE 135, LAVEEN, AZ 85339-7394
(602) 237-0613
(602) 237-0365
Mailing address
17000 RED HILL AVE, IRVINE, CA 92614-5626
(714) 845-8890
(949) 474-1495
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/04/2010
Last updated
12/31/2013
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