# EAST SCOTTSDALE PEDIATRIC DENTAL, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dental Associates For Kids Only
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073982997
- **Authorized official:** DR. CANDACE H VENEBERG D.D.S (DIRECTOR)
- **Authorized official phone:** (501) 850-5110

## Contact information

- **Practice address:** 12020 E SHEA BLVD, STE 8, SCOTTSDALE, AZ 85259-4179
- **Practice address phone:** (480) 767-5600
- **Mailing address:** 12020 E SHEA BLVD, STE 8, SCOTTSDALE, AZ 85259-4179
- **Mailing address phone:** (480) 767-5600

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | D009209 | AZ | Yes |

## Other

- **Enumeration date:** 09/21/2015
- **Last updated:** 10/18/2015