Organization
EMBRACEABLE AZ LLC
Active
Other names
Comfort Braces West Mesa
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK STASI D.D.S. (PARTNER / OWNER)
(303) 549-1912
Entity
Organization
Contact information
Practice address
1130 S COUNTRY CLUB DR, SUITE 101, MESA, AZ 85210-4639
(480) 461-9866
Mailing address
1130 S COUNTRY CLUB DR, SUITE 101, MESA, AZ 85210-4639
(480) 461-9866
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
8340
AZ
Other
Enumeration date
10/18/2012
Last updated
10/18/2012
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