Organization
AESTHETIC FAMILY DENTISTRY PC
Active
Parent organization
AESTHETIC FAMILY DENTISTRY PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
AESTHETIC FAMILY DENTISTRY PC
Authorized official
DR. RUSSELL W. RODERICK DMD (DOCTOR)
(480) 515-0404
Entity
Organization
Contact information
Practice address
26232 N TATUM BLVD STE 400, PHOENIX, AZ 85050-7504
(480) 515-0404
(480) 515-2587
Mailing address
26232 N TATUM BLVD STE 400, PHOENIX, AZ 85050-7504
(480) 515-0404
(480) 515-2587
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4906
AZ
Other
Enumeration date
01/28/2009
Last updated
01/28/2009
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