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General NPI Number Information
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NPI Number | 1619463577
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Entity Type | Organization
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Legal Business Name | AZ SLEEP AND TMJ PLC
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Dates
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Enumeration Date | 07/03/2018
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Last Update Date | 07/03/2018
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Provider Practice Location Address
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Address Line | 10465 E PINNACLE PEAK PKWY STE 101
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-8099
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Country | US
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Telephone | 480-473-8920
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Fax |
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Provider Business Mailing Address
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Address Line | 10465 E PINNACLE PEAK PKWY STE 101
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-8099
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Country | US
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Telephone | 480-473-8920
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | SARA VIZCARRA
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Credential | DDS
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Telephone | 480-473-0615
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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