Healthcare Provider Details

I. General information

NPI: 1619166329
Provider Name (Legal Business Name): GREG PAFFORD D.D.S., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2007
Last Update Date: 10/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 E MONTEREY WAY
PHOENIX AZ
85012-2616
US

IV. Provider business mailing address

57 E MONTEREY WAY
PHOENIX AZ
85012-2616
US

V. Phone/Fax

Practice location:
  • Phone: 602-264-3234
  • Fax: 602-264-3273
Mailing address:
  • Phone: 602-264-3234
  • Fax: 602-264-3273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number3770
License Number StateAZ

VIII. Authorized Official

Name: DR. GREG PAFFORD
Title or Position: PRESIDENT/OWNER
Credential: DDS
Phone: 602-264-3234