Organization
ORAL & MAXILLOFACIAL SURGERY OF PHOENIX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLAS BEBEAU MD, DDS (MANAGING MANAGER)
(480) 745-2430
Entity
Organization
Contact information
Practice address
5410 N SCOTTSDALE RD STE B100, PARADISE VALLEY, AZ 85253-5907
(480) 745-2430
Mailing address
5410 N SCOTTSDALE RD STE B100, PARADISE VALLEY, AZ 85253-5907
(480) 745-2430
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
8403
AZ
Other
Enumeration date
11/11/2013
Last updated
11/11/2013
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