Healthcare Provider Details

I. General information

NPI: 1306988258
Provider Name (Legal Business Name): DESERT PLASTIC SURGERY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 08/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9977 N 90TH ST STE 178
SCOTTSDALE AZ
85258-4426
US

IV. Provider business mailing address

9977 N 90TH ST STE 178
SCOTTSDALE AZ
85258-4426
US

V. Phone/Fax

Practice location:
  • Phone: 480-990-8808
  • Fax: 480-990-2240
Mailing address:
  • Phone: 480-990-8808
  • Fax: 480-990-2240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN M PIERCE
Title or Position: DOCTOR
Credential: MD
Phone: 480-990-8808