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NPI Code Detail

MEDICARE: EMBREE DDS PLLC

MEDICARE: EMBREE DDS PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1083444210
Entity Type Code : Organization
Provider Name (Legal Business Name) : EMBREE DDS PLLC
Provider Business Mailing Address
First Line : 2824 N POWER RD STE 108
Second Line :
City : MESA
State : AZ
Zip : 85215-1673
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2824 N POWER RD STE 108
Second Line :
City : MESA
State : AZ
Zip : 85215-1673
Country : US
Telephone Number : 480-641-4567
Fax Number :
Authorized Official
Title or Position : DENTIST OWNER
Name : BREANNA EMBREE
Credential : DDS
Telephone Number : 480-641-4567
Provider Enumeration Date : 08/02/2024
Last Update Date : 08/02/2024

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