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NPI Code Detail

MEDICARE: BRANDON WENTZ DMD

MEDICARE:   BRANDON  WENTZ  DMD
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
1122300000XDentistD011825AZ

General Provider Information

NPI Number : 1932883162
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDON WENTZ DMD
Provider Business Mailing Address
First Line : 6901 E CHAUNCEY LN
Second Line :
City : PHOENIX
State : AZ
Zip : 85054-5101
Country : US
Telephone Number : 520-904-0738
Fax Number :
Provider Business Practice Location Address
First Line : 4201 E BELL RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85032-2211
Country : US
Telephone Number : 480-605-3666
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2023
Last Update Date : 06/08/2023

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Directions to “ BRANDON WENTZ DMD” Practice Location

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