| Scottsdale Dental Group, Plc | |
|
4444 N 32nd St Ste 100 Phoenix AZ 85018-3956 | |
| (602) 612-2262 | |
| (602) 581-3344 |
| Full Name | Scottsdale Dental Group, Plc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4444 N 32nd St Ste 100, Phoenix, Arizona |
| Authorized Official Name and Position | Jennifer Terese Ebner (OWNER/DENTIST) |
| Authorized Official Contact | 6026122262 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Scottsdale Dental Group, Plc 4444 N 32nd St Ste 100 Phoenix AZ 85018-3956 Ph: (602) 612-2262 | Scottsdale Dental Group, Plc 4444 N 32nd St Ste 100 Phoenix AZ 85018-3956 Ph: (602) 612-2262 |
| NPI Number | 1083264154 |
|---|---|
| Provider Enumeration Date | 09/19/2019 |
| Last Update Date | 09/19/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083264154 | NPI | - | NPPES |
| 626192 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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