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General NPI Number Information
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NPI Number | 1003306325
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Entity Type | Organization
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Legal Business Name | SCOTTSDALE CENTER FOR DENTAL IMPLANTS LLC
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Dates
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Enumeration Date | 05/11/2018
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Last Update Date | 05/11/2018
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Provider Practice Location Address
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Address Line | 17235 N 75TH AVE STE C135
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City | GLENDALE
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State | AZ
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Zip | 85308-0880
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Country | US
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Telephone | 503-989-8149
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Fax |
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Provider Business Mailing Address
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Address Line | 17235 N 75TH AVE STE C135
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City | GLENDALE
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State | AZ
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Zip | 85308-0880
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANA-MARIA DOBRA
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Credential |
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Telephone | 503-989-8149
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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