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NPI Code Detail

MEDICARE: JUSTIN WATERS PLLC

MEDICARE: JUSTIN WATERS PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1023827391
Entity Type Code : Organization
Provider Name (Legal Business Name) : JUSTIN WATERS PLLC
Provider Business Mailing Address
First Line : 8390 E VIA DE VENTURA STE F200
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85258-3177
Country : US
Telephone Number : 480-466-6399
Fax Number :
Provider Business Practice Location Address
First Line : 8390 E VIA DE VENTURA STE F200
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85258-3177
Country : US
Telephone Number : 480-466-6399
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. JUSTIN JAMES WATERS
Credential : DMD
Telephone Number : 480-400-5000
Provider Enumeration Date : 01/02/2025
Last Update Date : 01/02/2025

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Directions to “JUSTIN WATERS PLLC ” Practice Location

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