Provider Demographics
NPI:1922702505
Name:HAREMZA DENTISTRY PLLC
Entity Type:Organization
Organization Name:HAREMZA DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRAXTON
Authorized Official - Middle Name:
Authorized Official - Last Name:HAREMZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-550-5885
Mailing Address - Street 1:16578 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80023-8964
Mailing Address - Country:US
Mailing Address - Phone:303-280-2285
Mailing Address - Fax:
Practice Address - Street 1:16578 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80023-8964
Practice Address - Country:US
Practice Address - Phone:303-280-2285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty