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General NPI Number Information
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NPI Number | 1649903469
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Entity Type | Organization
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Legal Business Name | DANI DENTAL STUDIO
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Dates
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Enumeration Date | 07/08/2022
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Last Update Date | 07/08/2022
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Provider Practice Location Address
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Address Line | 1243 E BROADWAY RD STE 201
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City | TEMPE
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State | AZ
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Zip | 85282-1530
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Country | US
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Telephone | 480-449-0909
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Fax |
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Provider Business Mailing Address
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Address Line | 1243 E BROADWAY RD STE 201
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City | TEMPE
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State | AZ
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Zip | 85282-1530
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Country | US
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Telephone | 480-449-0909
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Fax |
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Authorized Official
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Title or Position | ACCOUNT EXEC
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Name | GABIE DOBRIKOV
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Credential |
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Telephone | 602-561-6566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 292200000X
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Taxonomy Name | Dental Laboratory
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License Number |
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License Number State |
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