Organization
75TH AVENUE DENTISTRY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAROLL ANN GRAZIANO (MANAGER)
(623) 225-6555
Entity
Organization
Contact information
Practice address
7545 W. BELL RD, SUITE 105, PEORIA, AZ 85382-4764
(623) 412-2461
(623) 979-7364
Mailing address
23525 N. 67TH AVE, GLENDALE, AZ 85310
(623) 225-6555
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D5988
AZ
122300000X
Dentist
Primary
D6772
AZ
Other
Enumeration date
03/21/2007
Last updated
03/18/2009
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