Healthcare Provider Details

I. General information

NPI: 1881925808
Provider Name (Legal Business Name): NORTH SCOTTSDALE ENDODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2010
Last Update Date: 01/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8765 E BELL RD STE. 213
SCOTTSDALE AZ
85260-1319
US

IV. Provider business mailing address

8765 E. BELL RD., STE. 213
SCOTTSDALE AZ
85260
US

V. Phone/Fax

Practice location:
  • Phone: 480-731-3636
  • Fax: 480-731-3637
Mailing address:
  • Phone: 480-731-3636
  • Fax: 480-731-3637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number6383
License Number StateAZ

VIII. Authorized Official

Name: DR. THOMAS V MCCLAMMY
Title or Position: OWNER
Credential: D.M.D.
Phone: 480-731-3636