=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992998249
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DENISE AMELIA MILLS D.D.S.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/21/2007
-----------------------------------------------------
Last Update Date | 08/21/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7500 E ANGUS DR SUITE 1
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85251-6419
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-424-7886
-----------------------------------------------------
Fax | 480-424-7850
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7500 E ANGUS DR SUITE 1
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85251-6419
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-424-7886
-----------------------------------------------------
Fax | 480-424-7850
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | AZ3589
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------