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Contact Information

SOUTHERN DENTAL
3320 W. SOUTHERN AVENUE
SUITE # 108
PHOENIX, AZ85041
 Phone: 602-305-8800
 Fax: 602-305-8801
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for SOUTHERN DENTAL · (Female)

NPI # 1265616213
Status Active
Credentials
Entity Individual
Enumeration date 12/27/2007
Last updated 12/27/2007 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • AZ License # 5995
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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