Provider Demographics
NPI:1184018434
Name:WESTSIDE ENDODONTIC PROFESSIONALS, LTD.
Entity Type:Organization
Organization Name:WESTSIDE ENDODONTIC PROFESSIONALS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:STEINBRUNNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-939-3314
Mailing Address - Street 1:18555 N 79TH AVE
Mailing Address - Street 2:SUITE D104
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-8370
Mailing Address - Country:US
Mailing Address - Phone:623-939-3313
Mailing Address - Fax:
Practice Address - Street 1:18555 N 79TH AVE
Practice Address - Street 2:SUITE D104
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8370
Practice Address - Country:US
Practice Address - Phone:623-939-3313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-25
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty