Organization
ANDREW E FORMAN ORTHODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW E FORMAN DDS MS (MANAGER)
(602) 843-1000
Entity
Organization
Contact information
Practice address
20100 N 51ST AVE, SUITE B230, GLENDALE, AZ 85308-5125
(602) 843-1000
(480) 443-7165
Mailing address
7119 E SHEA BLVD, SUITE # 109-312, SCOTTSDALE, AZ 85254-6107
(602) 843-1000
(480) 443-7165
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
1625
AZ
Other
Enumeration date
12/05/2006
Last updated
01/26/2011
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