Organization
ASSOCIATED FAMILY DENTISTRY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LETISHA J HAWTHORNE (OFFICE MANAGER)
(623) 931-9221
Entity
Organization
Contact information
Practice address
9160 N 43RD AVE, GLENDALE, AZ 85302-3801
(623) 931-9221
(623) 937-4315
Mailing address
9160 N 43RD AVE, GLENDALE, AZ 85302-3801
(623) 931-9221
(623) 937-4315
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
AZ1926
AZ
Other
Enumeration date
03/13/2007
Last updated
08/22/2020
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