Provider Demographics
NPI:1447961586
Name:BRIMLEY DENTAL PLLC
Entity type:Organization
Organization Name:BRIMLEY DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-243-6900
Mailing Address - Street 1:2320 E BASELINE RD STE 160
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85042-6951
Mailing Address - Country:US
Mailing Address - Phone:602-243-6900
Mailing Address - Fax:602-243-6902
Practice Address - Street 1:2320 E BASELINE RD STE 160
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-6951
Practice Address - Country:US
Practice Address - Phone:602-243-6900
Practice Address - Fax:602-243-6902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-09
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty