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General NPI Number Information
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NPI Number | 1023235108
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Entity Type | Organization
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Legal Business Name | ORTHODONTIC CENTERS OF AZ
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1959 S VAL VISTA DR #118
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City | MESA
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State | AZ
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Zip | 85204-7356
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Country | US
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Telephone | 480-539-1000
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Fax | 480-539-9900
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Provider Business Mailing Address
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Address Line | 1959 S VAL VISTA DR #118
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City | MESA
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State | AZ
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Zip | 85204-7356
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Country | US
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Telephone | 480-539-1000
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Fax | 480-539-9900
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. DAVID B DOWLING
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Credential | D.D.S., M.S., PC
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Telephone | 480-539-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 1692
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License Number State | AZ
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