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General NPI Number Information
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NPI Number | 1336597236
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Entity Type | Organization
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Legal Business Name | SCOTTSDALE GENTLE TOOTH DOCTOR PLLC
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Dates
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Enumeration Date | 06/01/2016
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Last Update Date | 06/01/2016
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Provider Practice Location Address
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Address Line | 10335 N SCOTTSDALE RD STE E
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City | SCOTTSDALE
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State | AZ
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Zip | 85253-1435
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Country | US
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Telephone | 480-991-3273
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Fax |
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Provider Business Mailing Address
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Address Line | 5638 E THOMAS RD
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City | PHOENIX
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State | AZ
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Zip | 85018-8117
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Country | US
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Telephone | 480-990-2343
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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. BRYAN T TRAN
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Credential |
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Telephone | 480-250-2570
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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 | 5745
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License Number State | AZ
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