Healthcare Provider Details

I. General information

NPI: 1346310513
Provider Name (Legal Business Name): DAVID B FOLEY D.D.S., M.S., P.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 10/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4202 N 32ND ST SUITE K
PHOENIX AZ
85018-4746
US

IV. Provider business mailing address

4202 N 32ND ST SUITE K
PHOENIX AZ
85018-4746
US

V. Phone/Fax

Practice location:
  • Phone: 602-956-6355
  • Fax: 602-956-0649
Mailing address:
  • Phone: 602-956-6355
  • Fax: 602-956-0649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number3606
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: