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General NPI Number Information
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NPI Number | 1922303569
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Entity Type | Organization
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Legal Business Name | TOTAL FREEDOM DENTAL IMPLANT CENTER
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Dates
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Enumeration Date | 01/12/2011
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Last Update Date | 01/12/2011
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Provider Practice Location Address
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Address Line | 9002 E DESERT COVE AVE #101
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-6710
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Country | US
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Telephone | 480-860-9002
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Fax | 480-451-9378
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Provider Business Mailing Address
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Address Line | 9002 E DESERT COVE AVE #101
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-6710
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Country | US
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Telephone | 480-860-9002
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Fax | 480-451-9378
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Authorized Official
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Title or Position | PARTNER
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Name | DR. THOMAS M. SIMS
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Credential | D.D.S.
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Telephone | 480-860-9002
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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 | 3573
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License Number State | AZ
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