Organization
PHOENIX ORAL SURGERY ASSOCIATES PLLC
Active
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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