MEDICARE: SOMER DENTAL 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
1	122300000X	Dentist	5484	AZ

General Provider Information

NPI Number	:	1063684017
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOMER DENTAL PLLC

Provider Business Mailing Address
First Line	:	7625 W LOWER BUCKEYE RD
Second Line	:	SUITE 130
City	:	PHOENIX
State	:	AZ
Zip	:	85043-3446
Country	:	US
Telephone Number	:	623-907-8282
Fax Number	:	623-742-9580

Provider Business Practice Location Address
First Line	:	7625 W LOWER BUCKEYE RD
Second Line	:	SUITE 130
City	:	PHOENIX
State	:	AZ
Zip	:	85043-3446
Country	:	US
Telephone Number	:	623-907-8282
Fax Number	:	623-742-9580

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	DR. DAVID MARCUS CHEI
Credential	:	D.M.D.
Telephone Number	:	623-907-8282

Provider Enumeration Date	:	03/31/2008
Last Update Date	:	03/31/2008

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