Organization
GEISHUN MANAGEMENT, INC
Active
Other names
Open Wide Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS DURISEK DDS (PRESIDENT)
(602) 347-9999
Entity
Organization
Contact information
Practice address
6520 N 7TH AVE, STE#1, PHOENIX, AZ 85013-1173
(602) 347-9999
(602) 249-7460
Mailing address
6520 N 7TH AVE, STE#1, PHOENIX, AZ 85013-1173
(602) 347-9999
(602) 249-7460
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/15/2012
Last updated
03/15/2012
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