Organization
ASSOCIATED FAMILY DENTISTRY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LETISHA J. HAWTHORNE (OFFICE MANGER)
(623) 931-9221
Entity
Organization
Contact information
Practice address
9160 N 43RD AVE, GLENDALE, AZ 85302-3801
(623) 931-9221
(632) 937-4315
Mailing address
9160 N 43RD AVE, GLENDALE, AZ 85302-3801
(623) 931-9221
(632) 937-4315
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1926
AZ
1223G0001X
General Practice Dentistry
4315
AZ
Other
Enumeration date
03/14/2007
Last updated
08/22/2020
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