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General NPI Number Information
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NPI Number | 1477557726
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Entity Type | Individual
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Provider Name | STACEY LOUISE SANFORD DDS, MS
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Gender | Female
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 03/09/2016
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Provider Practice Location Address
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Address Line | 4124 N 82ND ST
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-2730
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Country | US
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Telephone | 480-423-3838
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Fax | 480-941-4544
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Provider Business Mailing Address
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Address Line | 1701 E THOMAS RD STE 204
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City | PHOENIX
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State | AZ
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Zip | 85016-7675
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Country | US
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Telephone | 602-253-6600
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Fax | 602-733-6480
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4768
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License Number State | AZ
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