Provider Demographics
NPI:1447469044
Name:AFFILIATED DENTISTS OF SCOTTSDALE, LTD.
Entity type:Organization
Organization Name:AFFILIATED DENTISTS OF SCOTTSDALE, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-949-5569
Mailing Address - Street 1:8040 E INDIAN SCHOOL RD # 110
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-2612
Mailing Address - Country:US
Mailing Address - Phone:480-949-5569
Mailing Address - Fax:480-949-8395
Practice Address - Street 1:8040 E INDIAN SCHOOL RD # 110
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-2612
Practice Address - Country:US
Practice Address - Phone:480-949-5569
Practice Address - Fax:480-949-8395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ18451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty