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General NPI Number Information
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NPI Number | 1710872379
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Entity Type | Individual
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Provider Name | ELYCE CEDERHOLM DDS
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Gender | Female
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Dates
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Enumeration Date | 06/12/2025
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 5425 E BELL RD STE 143
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-6010
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Country | US
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Telephone | 480-613-3476
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Fax |
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Provider Business Mailing Address
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Address Line | 5408 E DEW DROP TRL
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City | CAVE CREEK
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State | AZ
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Zip | 85331-2245
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Country | US
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Telephone | 360-921-4252
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | D012524
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License Number State | AZ
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