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1912538497
DENTAL DEPOT OF SURPRISE, PLLC
SURPRISE, AZ
NPI
1912538497
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Entity Type
Organization
Authorized Contact
GAYLON ZISSA
Professional Relations Manager
405-945-8941
Organization Subpart ?
No
Primary Taxonomy
261QD0000X Clinic/Center, Dental
Enumeration Date
2020-02-03
Last Update Date
2021-06-25
Business Address
DENTAL DEPOT OF SURPRISE, PLLC
13828 W. GREENWAY RD.
SURPRISE, AZ 85374
Phone number: 623-562-9123
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Mailing Address
DENTAL DEPOT OF SURPRISE, PLLC
2828 NW 30TH ST
OKLAHOMA CITY, OK 73112-7404
Phone number: 623-562-9123
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