Provider Demographics
NPI:1578759957
Name:MCDOWELL DENTISTRY, LLC
Entity Type:Organization
Organization Name:MCDOWELL DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:R
Authorized Official - Last Name:AYOUB
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-944-0076
Mailing Address - Street 1:14122 W MCDOWELL RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-2503
Mailing Address - Country:US
Mailing Address - Phone:602-944-0073
Mailing Address - Fax:602-944-0371
Practice Address - Street 1:2323 W MESCAL ST
Practice Address - Street 2:SUITE 205
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-4764
Practice Address - Country:US
Practice Address - Phone:602-944-0073
Practice Address - Fax:602-944-0371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD6399122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty