Provider Demographics
NPI:1083632780
Name:ACCUCARE DENTAL CENTERS PC
Entity Type:Organization
Organization Name:ACCUCARE DENTAL CENTERS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLCOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-998-8073
Mailing Address - Street 1:5830 W THUNDERBIRD RD STE B8-310
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-4654
Mailing Address - Country:US
Mailing Address - Phone:623-521-9120
Mailing Address - Fax:
Practice Address - Street 1:6949 E SHEA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-6146
Practice Address - Country:US
Practice Address - Phone:480-998-8073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty