Healthcare Provider Details

I. General information

NPI: 1588729081
Provider Name (Legal Business Name): SUNDANCE ENDODONTICS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13360 N 94TH DR SUITE C
PEORIA AZ
85381-4837
US

IV. Provider business mailing address

7127 E THIRSTY CACTUS LN
SCOTTSDALE AZ
85262-7307
US

V. Phone/Fax

Practice location:
  • Phone: 623-933-1986
  • Fax:
Mailing address:
  • Phone: 410-916-0817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number6548
License Number StateAZ

VIII. Authorized Official

Name: DR. BETTY SCHINDLER
Title or Position: PRESIDENT
Credential: M.B.A., D.D.S.
Phone: 623-933-1986