MEDICARE: AUSTROCYLINDROPUNTIA, LLC

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
1	122300000X	Dentist

General Provider Information

NPI Number	:	1578954194
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUSTROCYLINDROPUNTIA, LLC

Provider Business Mailing Address
First Line	:	4235 N 32ND ST
Second Line	:	SUITE A
City	:	PHOENIX
State	:	AZ
Zip	:	85018-4766
Country	:	US
Telephone Number	:	602-957-3808
Fax Number	:	602-957-3830

Provider Business Practice Location Address
First Line	:	4235 N 32ND ST
Second Line	:	SUITE A
City	:	PHOENIX
State	:	AZ
Zip	:	85018-4766
Country	:	US
Telephone Number	:	602-957-3808
Fax Number	:	602-957-3830

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	DR. CURT HAMANN
Credential	:	MD
Telephone Number	:	602-957-3808

Provider Enumeration Date	:	02/18/2015
Last Update Date	:	02/27/2015

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