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Organization
SCOTTSDALE IMPLANT AND COSMETIC DENTISTRY LLC
Active
Organization
SCOTTSDALE IMPLANT AND COSMETIC DENTISTRY LLC
Active
Parent organization
VALLEY IMPLANT CENTERS PLLC
Other names
Scottsdale Implant and Cosmetic Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
VALLEY IMPLANT CENTERS PLLC
Authorized official
MRS. PORTIA L FREDSTRUP (OWNER)
(602) 303-5827
Entity
Organization
Contact information
Practice address
4910 E GREENWAY RD STE 7, SCOTTSDALE, AZ 85254-1653
(480) 200-3453
Mailing address
7547 S FRONTIER ST, GILBERT, AZ 85298-0130
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D009808
AZ
Other
Enumeration date
04/13/2018
Last updated
06/16/2018
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