Healthcare Provider Details

I. General information

NPI: 1467548560
Provider Name (Legal Business Name): DAVID P GRIFFITH DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 05/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6535 W. CAMELBACK ROAD SUITE 3
PHOENIX AZ
85033
US

IV. Provider business mailing address

6535 W. CAMELBACK ROAD SUITE 3
PHOENIX AZ
85033
US

V. Phone/Fax

Practice location:
  • Phone: 623-846-7557
  • Fax: 623-846-7595
Mailing address:
  • Phone: 623-846-7557
  • Fax: 623-846-7595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License NumberAZ1704
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDS017502L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: