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General NPI Number Information
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NPI Number | 1992317143
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Entity Type | Individual
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Provider Name | JUSTIN S DOLE DMD
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Gender | Male
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Dates
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Enumeration Date | 08/19/2020
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 17767 N SCOTTSDALE RD STE 110
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-6590
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Country | US
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Telephone | 602-666-5805
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Fax |
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Provider Business Mailing Address
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Address Line | 17767 N SCOTTSDALE RD STE 110
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-6590
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Country | US
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Telephone | 602-666-5805
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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 | D010713
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License Number State | AZ
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