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General NPI Number Information
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NPI Number | 1154560316
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Entity Type | Organization
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Legal Business Name | SIGNATURE DENTISTRY
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Dates
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Enumeration Date | 02/11/2009
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Last Update Date | 03/19/2009
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Provider Practice Location Address
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Address Line | 10855 N FRANK LLOYD WRIGHT BLVD STE 105
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-4064
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Country | US
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Telephone | 480-451-1215
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Fax | 480-314-4181
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Provider Business Mailing Address
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Address Line | 11445 E VIA LINDA STE 2 PMB #612
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-2655
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Country | US
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Telephone | 481-451-1215
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Fax | 480-314-4181
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Authorized Official
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Title or Position | DENTIST
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Name | DR. HOWARD SOMMERS
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Credential | D.D.S
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Telephone | 480-451-1215
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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 | 4325
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License Number State | AZ
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