Healthcare Provider Details
I. General information
NPI: 1477326429
Provider Name (Legal Business Name): SAIZ DESERT WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/01/2023
Last Update Date: 11/02/2023
Certification Date: 11/02/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5555 W THUNDERBIRD RD
GLENDALE AZ
85306-4622
US
IV. Provider business mailing address
19025 N 99TH ST
SCOTTSDALE AZ
85255-6258
US
V. Phone/Fax
- Phone: 702-204-0725
- Fax:
- Phone: 702-204-0725
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223S0112X |
| Taxonomy | Oral and Maxillofacial Surgery (Dentist) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ERIC
EDWARD
SAIZ
Title or Position: MANAGER
Credential: DMD
Phone: 702-204-0725