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NPI Code Detail

MEDICARE: ASSOCIATED FAMILY DENTISTRY LTD

MEDICARE: ASSOCIATED FAMILY DENTISTRY LTD
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
1122300000XDentistAZ1926AZ

General Provider Information

NPI Number : 1942333513
Entity Type Code : Organization
Provider Name (Legal Business Name) : ASSOCIATED FAMILY DENTISTRY LTD
Provider Business Mailing Address
First Line : 9160 N 43RD AVE
Second Line :
City : GLENDALE
State : AZ
Zip : 85302-3801
Country : US
Telephone Number : 623-931-9221
Fax Number : 623-937-4315
Provider Business Practice Location Address
First Line : 9160 N 43RD AVE
Second Line :
City : GLENDALE
State : AZ
Zip : 85302-3801
Country : US
Telephone Number : 623-931-9221
Fax Number : 623-937-4315
Authorized Official
Title or Position : OFFICE MANAGER
Name : MRS. LETISHA J HAWTHORNE
Credential :
Telephone Number : 623-931-9221
Provider Enumeration Date : 03/13/2007
Last Update Date : 08/22/2020

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Directions to “ASSOCIATED FAMILY DENTISTRY LTD ” Practice Location

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