Organization
WILD WEST ORTHODONTICS P.C
Active
Organization
WILD WEST ORTHODONTICS P.C
Active
Other names
Wild West Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY H RUIZ (REGIONAL MANAGER)
(623) 536-2040
Entity
Organization
Contact information
Practice address
14122 W MCDOWELL RD, 200, GOODYEAR, AZ 85395-2503
(623) 535-6603
Mailing address
14122 W MCDOWELL RD, 200, GOODYEAR, AZ 85395-2503
(623) 535-6603
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
06/03/2016
Last updated
06/06/2016
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