National Provider Identifier Database

DENTAL AND BRACES MESA LLC
Health Service


Contact Information

DENTAL AND BRACES MESA LLC
1245 E SOUTHERN AVE STE 12
MESA, AZ85204-5138
Phone: 480-636-9970
Fax:
Website:
Specialty Taxonomy Code
* Health Service 261QH0100X

* Indicates primary specialty

NPI Profile & details for DENTAL AND BRACES MESA LLC

NPI Number 1659835932
Legal business name
LBN
DENTAL AND BRACES MESA LLC
Authorized official LIZ RAMOS - (MANAGER)
Entity Organization
Organization subpart No
Enumeration date 01/30/2019
Last updated 01/30/2019 - About 7 years ago
Sole proprietor1 Not specified
Identifiers
  • AZ Medicaid: 246754

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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