Organization
WSAT ENTERPRISES I, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FAWNE PRYOR (AR AND INSURANCE MANAGER)
(602) 944-0073
Entity
Organization
Contact information
Practice address
140 N LITCHFIELD RD STE 200, GOODYEAR, AZ 85338-1226
(623) 932-5130
(623) 932-9948
Mailing address
2323 W MESCAL ST STE 205, PHOENIX, AZ 85029-4764
(602) 944-0073
(602) 944-0371
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D5926
AZ
Other
Enumeration date
03/21/2007
Last updated
08/22/2020
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