Provider Demographics
NPI:1922276724
Name:JRA DENTAL, PLLC
Entity Type:Organization
Organization Name:JRA DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:ARTHURS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-750-3936
Mailing Address - Street 1:3750 W GREENWAY RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053
Mailing Address - Country:US
Mailing Address - Phone:602-750-3936
Mailing Address - Fax:
Practice Address - Street 1:3750 W. GREENWAY RD.
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85053
Practice Address - Country:US
Practice Address - Phone:602-750-3936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ58181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty