Az Life Dentistry, Pllc

NPI #1497046395 in Avondale, Arizona

Provider Information

NPI Number: 1497046395
Entity Type: Organization
Organization Name: Az Life Dentistry, Pllc
Primary Specialty: Dentist
Enumeration Date: Apr 26, 2011
Last Updated: Apr 26, 2011

Practice Location

Address: 13065 W MCDOWELL RD
Address 2: BUILDING B, SUITE #112
City: Avondale
State: Arizona
ZIP Code: 85392-6439
Phone: (623) 455-3600

Authorized Official

Name: DR. SHAHAB ARDALAN, DDS
Title: MANAGING MEMBER
Phone: (480) 861-5261

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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