Provider Demographics
NPI:1588786511
Name:SEVILLE FAMILY DENTISTRY PLC
Entity type:Organization
Organization Name:SEVILLE FAMILY DENTISTRY PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAUER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-279-4790
Mailing Address - Street 1:3336 E CHANDLER HEIGHTS RD
Mailing Address - Street 2:SUITE 119
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-4259
Mailing Address - Country:US
Mailing Address - Phone:480-279-4790
Mailing Address - Fax:480-279-9829
Practice Address - Street 1:3336 E CHANDLER HEIGHTS RD
Practice Address - Street 2:SUITE 119
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-4259
Practice Address - Country:US
Practice Address - Phone:480-279-4790
Practice Address - Fax:480-279-9829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD5909122300000X
AZD5852122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty