Provider Demographics
NPI:1023449386
Name:ARIZONA ORTHODONITC CONTRACTING PLLC
Entity type:Organization
Organization Name:ARIZONA ORTHODONITC CONTRACTING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZWICKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-866-8811
Mailing Address - Street 1:1426 W PRINCE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-3014
Mailing Address - Country:US
Mailing Address - Phone:520-722-2900
Mailing Address - Fax:520-798-2418
Practice Address - Street 1:1426 W PRINCE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-3014
Practice Address - Country:US
Practice Address - Phone:520-722-2900
Practice Address - Fax:520-798-2418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-11
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD058601223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty