Organization
THUNDERBIRD DENTAL TRUST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY M BECKER DDS (TRUSTEE)
(623) 979-9454
Entity
Organization
Contact information
Practice address
13980 N 67TH AVE STE 2, GLENDALE, AZ 85306-3715
(623) 979-9454
(623) 979-9474
Mailing address
13980 N 67TH AVE STE 2, GLENDALE, AZ 85306-3715
(623) 979-9454
(623) 979-9474
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2890
AZ
Other
Enumeration date
02/21/2007
Last updated
08/22/2020
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