MEDICARE: FAMILIES DENTISTRY

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	1223G0001X	General Practice Dentistry	D7588	AZ

General Provider Information

NPI Number	:	1265701684
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILIES DENTISTRY

Provider Business Mailing Address
First Line	:	4502 W INDIAN SCHOOL RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85031-2800
Country	:	US
Telephone Number	:	623-873-2131
Fax Number	:	623-973-2723

Provider Business Practice Location Address
First Line	:	4502 W INDIAN SCHOOL RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85031-2800
Country	:	US
Telephone Number	:	623-873-2131
Fax Number	:	623-973-2723

Authorized Official
Title or Position	:	OWNER
Name	:	COLIA ADAMS
Credential	:
Telephone Number	:	602-643-5678

Provider Enumeration Date	:	12/14/2011
Last Update Date	:	12/14/2011

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Directions to “FAMILIES DENTISTRY ” Practice Location

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