Burgardt and Diaz Dental Group, Pllc

NPI #1972128858 in Peoria, Arizona

Provider Information

NPI Number: 1972128858
Entity Type: Organization
Organization Name: Burgardt and Diaz Dental Group, Pllc
Primary Specialty: Dentist - Periodontics
Enumeration Date: Jun 16, 2020
Last Updated: Jul 1, 2020

Practice Location

Address: 13260 N 94TH DR STE 410
City: Peoria
State: Arizona
ZIP Code: 85381-4241
Phone: (620) 260-5655

Authorized Official

Name: DR. GRAYSON JOHN BURGARDT, DDS, MSD
Title: MEMBER, MANAGER, AND EMPLOYEE
Phone: (620) 260-5655

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Periodontics — Periodontics	1223P0300X	Primary

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