TATUM BLVD DENTISTRY, LLC

PHOENIX, AZ
NPI1104034909
Entity TypeOrganization
Authorized ContactBRAD WYATT
Dentist
602-944-0073
Organization Subpart ?No
Primary Taxonomy122300000X Dentist
(Licence: AZ  D5926)
Enumeration Date2007-05-18
Last Update Date2020-08-22
Business Address
TATUM BLVD DENTISTRY, LLC
11110 N TATUM BLVD SUITE 102
PHOENIX, AZ 85028-1607
Phone number: 602-977-1110
Mailing Address
TATUM BLVD DENTISTRY, LLC
2323 W MESCAL ST SUITE 205
PHOENIX, AZ 85029-4764
Phone number: 602-944-0073
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