Provider Demographics
NPI:1508306762
Name:BRIGGS, MOLLY DANIELLE (DDS)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:DANIELLE
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 E BROWN RD STE 4
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-4958
Mailing Address - Country:US
Mailing Address - Phone:585-489-9498
Mailing Address - Fax:
Practice Address - Street 1:855 E BROWN RD STE 4
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-4958
Practice Address - Country:US
Practice Address - Phone:931-286-0536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-06
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9929122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist