NPI 1013126101

Raymond McReady Travis Vanderwerf, DDSCAGS

Practitioner Endodontics Mesa, AZ

Practice location

Address: 1630 S Stapley Dr #208, Mesa, AZ 85204-6657
Phone: (480) 775-2656

Registered specialties

Endodontics Primary

Dental Providers Taxonomy 1223E0200X Licence 2117 (AZ)

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Registry record

NPI: 1013126101
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 May 2007
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.