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General NPI Number Information
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NPI Number | 1811552128
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Entity Type | Organization
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Legal Business Name | PAYSON DENTAL CARE PC
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Dates
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Enumeration Date | 05/02/2019
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Last Update Date | 01/18/2024
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Provider Practice Location Address
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Address Line | 13825 N NORTHSIGHT BLVD STE 120
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-3684
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Country | US
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Telephone | 480-767-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 315 E ST HWY 260
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City | PAYSON
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State | AZ
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Zip | 85541-4930
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Country | US
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Telephone | 928-474-2200
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JENNIFER MULLINS
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Credential |
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Telephone | 928-474-2200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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Taxonomy #2
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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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