Healthcare Provider Details

I. General information

NPI: 1235395435
Provider Name (Legal Business Name): TROND U HEGLE D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2008
Last Update Date: 04/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7521 N TATUM BLVD
PARADISE VALLEY AZ
85253-3377
US

IV. Provider business mailing address

7521 N TATUM BLVD
PARADISE VALLEY AZ
85253-3377
US

V. Phone/Fax

Practice location:
  • Phone: 480-381-5800
  • Fax:
Mailing address:
  • Phone: 480-381-5800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number7585
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: