Healthcare Provider Details

I. General information

NPI: 1831381086
Provider Name (Legal Business Name): DIANA A BATOON, DMD,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2007
Last Update Date: 08/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11111 N. SCOTTSDALE ROAD SUITE # 130
SCOTTSDALE AZ
85254-6734
US

IV. Provider business mailing address

11111 N. SCOTTSDALE ROAD SUITE # 130
SCOTTSDALE AZ
85254-6734
US

V. Phone/Fax

Practice location:
  • Phone: 480-776-0643
  • Fax:
Mailing address:
  • Phone: 480-776-0643
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4819
License Number StateAZ

VIII. Authorized Official

Name: DR. DIANA A BATOON
Title or Position: PRESIDENT
Credential: DMD
Phone: 480-776-0643