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Tatum Blvd Dentistry, LLC

NPI #1104034909 in Phoenix, Arizona

Provider Information

NPI Number
1104034909
Entity Type
Organization
Organization Name
Tatum Blvd Dentistry, LLC
Primary Specialty
Dentist
Enumeration Date
May 18, 2007
Last Updated
Aug 22, 2020

Practice Location

Address
11110 N TATUM BLVD
Address 2
SUITE 102
City
Phoenix
State
Arizona
ZIP Code
85028-1607
Phone
(602) 977-1110

Authorized Official

Name
DR. BRAD WYATT, DMD
Title
DENTIST
Phone
(602) 944-0073

Specialties & Taxonomy Codes

Specialty
Dentist

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