Organization · Type 2 NPI
Dental and Braces Roosevelt PLLC
Dental Clinic/Center · Phoenix, AZ
NPI number
1659836369
Active
Practice location
1602 E Roosevelt St Ste 301
Phoenix, AZ 85006-3678
Mailing address
1515 N Gilbert Rd Ste 107-131
Gilbert, AZ 85234-2318
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | None listed |
Dental Clinic/Center: Definition to come...
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About NPI 1659836369
Dental and Braces Roosevelt PLLC's National Provider Identifier is 1659836369, issued on Feb 6, 2019. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Phoenix, AZ. The record was last updated on Feb 6, 2019.