Organization
AGE DEFYING DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID J VELASCO DDS (MANAGER)
(480) 840-9200
Entity
Organization
Contact information
Practice address
21321 EAST OCOTILLO RD BLDG M, STE 130, QUEEN CREEK, AZ 85142
(480) 840-9200
Mailing address
21321 EAST OCOTILLO RD BLDG M, STE 130, QUEEN CREEK, AZ 85142
(480) 840-9200
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
AZ4044
AZ
Other
Enumeration date
05/28/2010
Last updated
05/28/2010
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