Individual
DR. JUSTIN VAN DUSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1700 E ELLIOT RD STE 7&8, TEMPE, AZ 85284-1630
(480) 674-6060
(480) 674-6070
Mailing address
18515 E MACAW DR, QUEEN CREEK, AZ 85142-5168
(949) 378-5967
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D008934
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
927061
—
AZ
Enumeration date
05/09/2014
Last updated
08/01/2024
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