NPI 1013020502

Bryce E. Justesen, DDS

Practitioner Dentist Mesa, AZ

Practice location

Address: 2830 E Brown Rd Suite 6, Mesa, AZ 85213-5430
Phone: (480) 835-5945
Fax: (480) 890-2176
Mailing address: 946 E. Hackamore St., Mesa, AZ 85203

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence D2731 (AZ)

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Registry record

NPI: 1013020502
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Aug 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.