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General NPI Number Information
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NPI Number | 1871931659
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Entity Type | Organization
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Legal Business Name | SW MOBILE DA
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Dates
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Enumeration Date | 06/13/2013
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Last Update Date | 06/13/2013
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Provider Practice Location Address
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Address Line | 13575 W INDIAN SCHOOL RD STE #1000
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-4901
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Country | US
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Telephone | 480-652-6958
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Fax | 424-230-7849
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Provider Business Mailing Address
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Address Line | 13575 W INDIAN SCHOOL RD STE #1000
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-4901
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Country | US
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Telephone | 480-652-6958
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Fax | 424-230-7849
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY NEIL BROWNSTEIN
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Credential | DDS
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Telephone | 480-652-6958
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | D5164
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License Number State | AZ
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