Healthcare Provider Details

I. General information

NPI: 1861607475
Provider Name (Legal Business Name): NOEL WILLIAM KORF DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9002 E DESERT COVE SUITE 100
SCOTTSDALE AZ
85260-6275
US

IV. Provider business mailing address

9002 E DESERT COVE SUITE 100
SCOTTSDALE AZ
85260-6275
US

V. Phone/Fax

Practice location:
  • Phone: 480-860-0008
  • Fax: 480-860-1855
Mailing address:
  • Phone: 480-860-0008
  • Fax: 480-860-1855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberAZ2090
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: