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General NPI Number Information
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NPI Number | 1740699396
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Entity Type | Organization
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Legal Business Name | THE FLOSS DRS, LLC
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Dates
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Enumeration Date | 08/07/2014
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Last Update Date | 08/07/2014
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Provider Practice Location Address
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Address Line | 4226 N 157TH AVE
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City | GOODYEAR
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State | AZ
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Zip | 85395-7797
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Country | US
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Telephone | 623-432-8040
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Fax |
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Provider Business Mailing Address
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Address Line | 4226 N 157TH AVE
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City | GOODYEAR
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State | AZ
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Zip | 85395-7797
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Country | US
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Telephone | 623-432-8040
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GREGG CURRY
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Credential |
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Telephone | 623-432-8040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | H006937
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License Number State | AZ
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