Healthcare Provider Details

I. General information

NPI: 1740334424
Provider Name (Legal Business Name): RICHARD DALOTTO FP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 03/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12641 N 70TH ST
SCOTTSDALE AZ
85254-5313
US

IV. Provider business mailing address

727 E BETHANY HOME RD SUITE A-101
PHOENIX AZ
85014-2198
US

V. Phone/Fax

Practice location:
  • Phone: 602-279-2400
  • Fax: 602-279-5890
Mailing address:
  • Phone: 602-795-7232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: