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General NPI Number Information
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NPI Number | 1467229054
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Entity Type | Organization
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Legal Business Name | 1-2-3 BREATHE FREE LLC
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Dates
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Enumeration Date | 12/05/2023
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Last Update Date | 12/05/2023
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Provider Practice Location Address
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Address Line | 10320 W MCDOWELL RD STE 3010
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City | AVONDALE
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State | AZ
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Zip | 85392-4867
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Country | US
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Telephone | 623-535-4194
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Fax |
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Provider Business Mailing Address
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Address Line | 18587 W MINNEZONA AVE
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City | GOODYEAR
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State | AZ
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Zip | 85395-4001
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL JONES SR.
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Credential |
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Telephone | 623-261-3564
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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