Healthcare Provider Details

I. General information

NPI: 1831381409
Provider Name (Legal Business Name): GARY F BERNARD DDS & ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2007
Last Update Date: 08/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7125 E LINCOLN DR #103
SCOTTSDALE AZ
85253
US

IV. Provider business mailing address

7125 E LINCOLN DR #103
SCOTTSDALE AZ
85253
US

V. Phone/Fax

Practice location:
  • Phone: 480-948-7000
  • Fax: 480-948-7531
Mailing address:
  • Phone: 480-948-7000
  • Fax: 480-948-7531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number6032
License Number StateAZ

VIII. Authorized Official

Name: DR. GARY FRANK BERNARD
Title or Position: OWNER PERIODONTIST
Credential: DDS
Phone: 480-948-7000