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General NPI Number Information
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NPI Number | 1083169759
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Entity Type | Organization
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Legal Business Name | UNIQUE VENTURES
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Dates
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Enumeration Date | 08/23/2016
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Last Update Date | 08/23/2016
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Provider Practice Location Address
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Address Line | 4390 N MILLER RD STE 106
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-3613
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Country | US
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Telephone | 480-949-5858
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Fax |
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Provider Business Mailing Address
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Address Line | 4390 N MILLER RD STE 106
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-3613
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Country | US
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Telephone | 480-949-5858
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. AARON JEZIORSKI
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Credential | DDS
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Telephone | 480-949-5858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D008478
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License Number State | AZ
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