Healthcare Provider Details

I. General information

NPI: 1265572036
Provider Name (Legal Business Name): PINNACLE PEAK ENDODONTICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 08/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 E PINNACLE PEAK RD SUITE A-100
SCOTTSDALE AZ
85255-3406
US

IV. Provider business mailing address

7500 E PINNACLE PEAK RD SUITE A-100
SCOTTSDALE AZ
85255-3406
US

V. Phone/Fax

Practice location:
  • Phone: 480-585-2824
  • Fax: 480-585-2391
Mailing address:
  • Phone: 480-585-2824
  • Fax: 480-585-2391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberD5158
License Number StateAZ

VIII. Authorized Official

Name: DR. DOUGLAS EUGENE THOMAS
Title or Position: OWNER/MANAGER
Credential: DDS
Phone: 480-585-2824