Individual
SOPHIA MARIE BEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
5144 W OLIVE AVE, GLENDALE, AZ 85302-4209
(623) 939-9944
Mailing address
25312 N 20TH AVE, PHOENIX, AZ 85085-8603
(321) 298-7668
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D012616
AZ
Other
Enumeration date
08/04/2025
Last updated
08/04/2025
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