# THE DENTAL BOUTIQUE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437791548
- **Authorized official:** DR. DARREN ANDERSON DMD (CEO)
- **Authorized official phone:** (480) 531-3631

## Contact information

- **Practice address:** 8075 E MORGAN TRL STE 3, SCOTTSDALE, AZ 85258-1213
- **Practice address phone:** (480) 531-3631
- **Mailing address:** 2128 W TALLGRASS TRL UNIT 216, PHOENIX, AZ 85085-0743
- **Mailing address phone:** (480) 531-3631

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 10/09/2019
- **Last updated:** 10/10/2019