Individual
DR. STEVEN VELASCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
17235 N 75TH AVE STE A100, GLENDALE, AZ 85308-0884
(623) 825-9445
Mailing address
4626 N 84TH LN, PHOENIX, AZ 85037-1543
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D011393
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D011393
ARIZONA STATE BOARD OF DENTAL EXAMINERS
AZ
Enumeration date
06/02/2022
Last updated
06/02/2022
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