Organization
AVELLE GILBERT ORTHO LLC
Active
Organization
AVELLE GILBERT ORTHO LLC
Active
Other names
Avelle Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ETHAN LARSON (DOCTOR)
(253) 283-2747
Entity
Organization
Contact information
Practice address
4365 E PECOS RD STE 136, GILBERT, AZ 85295-8053
(253) 283-2747
Mailing address
4365 E PECOS RD STE 136, GILBERT, AZ 85295-8053
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
02/20/2023
Last updated
02/20/2023
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