Age Defying Dentistry

NPI #1962721001 in Queen Creek, Arizona

Provider Information

NPI Number: 1962721001
Entity Type: Organization
Organization Name: Age Defying Dentistry
Primary Specialty: Dentist
Enumeration Date: May 28, 2010
Last Updated: May 28, 2010

Practice Location

Address: 21321 EAST OCOTILLO RD BLDG M, STE 130
City: Queen Creek
State: Arizona
ZIP Code: 85142
Phone: (480) 840-9200

Authorized Official

Name: DR. DAVID J VELASCO, DDS
Title: MANAGER
Phone: (480) 840-9200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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