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General NPI Number Information
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NPI Number | 1518344910
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Entity Type | Organization
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Legal Business Name | CDC GROUP INC
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Dates
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Enumeration Date | 05/05/2015
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Last Update Date | 05/05/2015
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Provider Practice Location Address
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Address Line | 7700 E INDIAN SCHOOL RD STE 3
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-4043
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Country | US
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Telephone | 480-941-7070
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Fax | 480-941-0067
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Provider Business Mailing Address
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Address Line | 7700 E INDIAN SCHOOL RD STE 3
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-4043
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Country | US
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Telephone | 480-941-7070
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Fax | 480-941-0067
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Authorized Official
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Title or Position | CEO
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Name | DR. ROY SHIM
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Credential | DDS
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Telephone | 480-941-7070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D7163
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License Number State | AZ
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