Healthcare Provider Details
I. General information
NPI: 1053123893
Provider Name (Legal Business Name): SNC DENTAL FH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/20/2025
Last Update Date: 01/20/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8980 N 90TH ST STE 130
SCOTTSDALE AZ
85258-5398
US
IV. Provider business mailing address
8980 N 90TH ST STE 130
SCOTTSDALE AZ
85258-5398
US
V. Phone/Fax
- Phone: 602-887-8373
- Fax:
- Phone: 602-887-8373
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DANIEL
KEYVANI
Title or Position: PRESIDENT
Credential: DDS
Phone: 310-351-4904