Laveen Modern Dentistry, LLP

NPI #1497064851 in Laveen, Arizona

Provider Information

NPI Number: 1497064851
Entity Type: Organization
Organization Name: Laveen Modern Dentistry, LLP
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 4, 2010
Last Updated: Dec 31, 2013

Practice Location

Address: 5045 W BASELINE RD STE 135
City: Laveen
State: Arizona
ZIP Code: 85339-7394
Phone: (602) 237-0613

Authorized Official

Name: DR. BRIAN NELSON, DMD
Title: OWNER DMD
Phone: (602) 237-0613

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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