| Open Wide Dental | |
|
6520 N 7th Ave Suite #1 Phoenix AZ 85013-1158 | |
| (602) 347-9999 | |
| Not Available |
| Full Name | Open Wide Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 6520 N 7th Ave, Phoenix, Arizona |
| Authorized Official Name and Position | Thomas Scott Durisek (PRESIDENT) |
| Authorized Official Contact | 6023479999 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Open Wide Dental 6520 N 7th Ave Suite #1 Phoenix AZ 85013-1158 Ph: () - | Open Wide Dental 6520 N 7th Ave Suite #1 Phoenix AZ 85013-1158 Ph: (602) 347-9999 |
| NPI Number | 1295919751 |
|---|---|
| Provider Enumeration Date | 12/19/2007 |
| Last Update Date | 12/19/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295919751 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 4777 (Arizona) | Primary |
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