Healthcare Provider Details

I. General information

NPI: 1871679019
Provider Name (Legal Business Name): GEORGE H MASTER DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 N SCOTTSDALE RD #226
SCOTTSDALE AZ
85251
US

IV. Provider business mailing address

3501 N SCOTTSDALE RD #226
SCOTTSDALE AZ
85251
US

V. Phone/Fax

Practice location:
  • Phone: 480-941-5005
  • Fax: 480-946-0268
Mailing address:
  • Phone: 480-941-5005
  • Fax: 480-946-0268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number2202
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: