Provider Demographics
NPI:1043497613
Name:WACHTEL, TARIANNE MARIE (DMD)
Entity type:Individual
Prefix:DR
First Name:TARIANNE
Middle Name:MARIE
Last Name:WACHTEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:TARIANNE
Other - Middle Name:MARIE
Other - Last Name:TEMPLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:8702 E IRISH HUNTER TRL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-1444
Mailing Address - Country:US
Mailing Address - Phone:602-751-0794
Mailing Address - Fax:
Practice Address - Street 1:9002 E DESERT COVE DR
Practice Address - Street 2:SUITE 208
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6275
Practice Address - Country:US
Practice Address - Phone:602-751-0794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-26
Last Update Date:2008-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD5129122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist