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General NPI Number Information
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NPI Number | 1962728881
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Entity Type | Organization
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Legal Business Name | SCOTTSDALE ORTHODONTIC ASSOCIATES INC
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Dates
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Enumeration Date | 04/16/2010
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Last Update Date | 04/16/2010
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Provider Practice Location Address
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Address Line | 9377 E BELL RD SUITE 185
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-1502
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Country | US
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Telephone | 480-948-4010
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Fax | 480-473-2181
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Provider Business Mailing Address
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Address Line | 9377 E BELL RD SUITE 185
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-1502
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Country | US
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Telephone | 480-948-4010
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Fax | 480-473-2181
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SEUSS KASSISIEH
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Credential | DDS, MS
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Telephone | 480-948-4010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 4721
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License Number State | AZ
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