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General NPI Number Information
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NPI Number | 1134366503
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Entity Type | Organization
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Legal Business Name | SCOTTSDALE SMILE CENTER
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Dates
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Enumeration Date | 01/07/2009
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Last Update Date | 01/07/2009
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Provider Practice Location Address
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Address Line | 7125 E LINCOLN DR STE 106
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City | SCOTTSDALE
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State | AZ
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Zip | 85253-4429
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Country | US
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Telephone | 480-609-9687
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Fax |
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Provider Business Mailing Address
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Address Line | 7125 E LINCOLN DR STE 106
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City | SCOTTSDALE
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State | AZ
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Zip | 85253-4429
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Country | US
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Telephone | 480-609-9687
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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. JONATHAN S COOMBS
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Credential | DMD
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Telephone | 480-609-9687
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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