Organization
DESERT RIDGE IMPLANT & ORAL SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW A. DEFELICE DDS (OWNER)
(480) 563-3960
Entity
Organization
Contact information
Practice address
20950 N TATUM BLVD, STE. 120, PHOENIX, AZ 85050-4200
(480) 563-3960
(480) 563-3965
Mailing address
20950 N TATUM BLVD, STE. 120, PHOENIX, AZ 85050-4200
(480) 563-3960
(480) 563-3965
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5196
AZ
Other
Enumeration date
02/09/2011
Last updated
04/04/2011
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