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General NPI Number Information
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NPI Number | 1356406110
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Entity Type | Organization
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Legal Business Name | DAVID S DEMAINE, DDS, PC
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4901 N 44TH ST SUITE 100
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City | PHOENIX
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State | AZ
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Zip | 85018-2782
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Country | US
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Telephone | 602-840-3760
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Fax |
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Provider Business Mailing Address
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Address Line | 4901 N 44TH ST SUITE 100
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City | PHOENIX
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State | AZ
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Zip | 85018-2782
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Country | US
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Telephone | 602-840-3760
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID S DEMAINE
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Credential | DDS
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Telephone | 602-840-3760
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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 | D2842
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License Number State | AZ
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