Organization
PHOENIX ORAL SURGERY ASSOCIATES PLLC
Active
Other names
Desert Ridge Oral Surgery Institute
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VISHTASB N/A BROUMAND DMD MD (OWNER)
(480) 284-8087
Entity
Organization
Contact information
Practice address
20950 N TATUM BLVD STE 200, PHOENIX, AZ 85050-4269
(480) 284-8087
Mailing address
20950 N TATUM BLVD STE 200, PHOENIX, AZ 85050-4269
(480) 284-8087
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
10/19/2022
Last updated
10/19/2022
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