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General NPI Number Information
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NPI Number | 1720618333
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Entity Type | Organization
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Legal Business Name | BRAD THE DENTIST, PLLC
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Dates
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Enumeration Date | 01/23/2020
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Last Update Date | 01/23/2020
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Provider Practice Location Address
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Address Line | 9304 E RAINTREE DR STE 100
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-7768
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Country | US
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Telephone | 480-586-1748
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Fax |
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Provider Business Mailing Address
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Address Line | 7501 E MCDOWELL RD APT 2106
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City | SCOTTSDALE
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State | AZ
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Zip | 85257-3566
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Country | US
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Telephone | 480-586-1748
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRAD PFEIFLE
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Credential | DDS
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Telephone | 480-586-1748
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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 |
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License Number State |
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