Dental and Braces Dysart LLC

NPI #1629676903 in Avondale, Arizona

Provider Information

NPI Number: 1629676903
Entity Type: Organization
Organization Name: Dental and Braces Dysart LLC
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Oct 9, 2020
Last Updated: Oct 9, 2020

Practice Location

Address: 1450 N DYSART RD STE A7
City: Avondale
State: Arizona
ZIP Code: 85323-1534
Phone: (623) 471-6962

Authorized Official

Name: ELIZABETH RAMOS
Title: CREDENTIALING
Phone: (602) 726-3221

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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