Glendale Modern Dentistry, LLP

NPI #1255757308 in Glendale, Arizona

Provider Information

NPI Number: 1255757308
Entity Type: Organization
Organization Name: Glendale Modern Dentistry, LLP
Primary Specialty: Dentist
Enumeration Date: Mar 13, 2014
Last Updated: Mar 13, 2014

Practice Location

Address: 5143 WEST OLIVE AVE, SUITE 140
City: Glendale
State: Arizona
ZIP Code: 85302
Phone: (623) 939-2600

Authorized Official

Name: MARISSA BROWN, DMD
Title: OWNER DOCTOR
Phone: (623) 939-2600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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