MEDICARE: D & M DENTAL

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1477196327
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	D & M DENTAL

Provider Business Mailing Address
First Line	:	1619 N DATE DR
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85281-1518
Country	:	US
Telephone Number	:	270-792-8644
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	:	602-842-5924
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SARAH MARIA GOFF
Credential	:	DMD
Telephone Number	:	270-792-8644

Provider Enumeration Date	:	10/23/2019
Last Update Date	:	10/23/2019

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Directions to “D & M DENTAL ” Practice Location

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