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General NPI Number Information
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NPI Number | 1194851790
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Entity Type | Organization
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Legal Business Name | ASSOCIATED DENTAL CARE PROVIDERS
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 09/18/2023
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Provider Practice Location Address
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Address Line | 7425 E SHEA BLVD STE 109
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-6411
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Country | US
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Telephone | 480-443-1717
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Fax | 480-443-1818
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Provider Business Mailing Address
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Address Line | 7425 E SHEA BLVD STE 109
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-6411
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Country | US
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Telephone | 480-443-1717
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Fax | 480-443-1818
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | MRS. HANNAH FISH
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Credential |
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Telephone | 217-540-5699
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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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