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General NPI Number Information
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NPI Number | 1548599541
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Entity Type | Organization
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Legal Business Name | SCOTTSDALE SEDATION MANAGEMENT, CO. LLC
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Dates
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Enumeration Date | 12/22/2009
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Last Update Date | 12/22/2009
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Provider Practice Location Address
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Address Line | 8600 E VIA DE VENTURA SUITE 202
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-3323
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Country | US
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Telephone | 480-948-4455
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Fax |
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Provider Business Mailing Address
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Address Line | 8600 E VIA DE VENTURA SUITE 202
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-3323
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Country | US
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Telephone | 480-948-4455
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. ALEXANDER SLEPAK
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Credential |
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Telephone | 215-327-3557
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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 | D7043
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License Number State | AZ
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