# OSBORN ROAD DENTAL LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Dentistry of Old Town Scottsdale
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912668641
- **Authorized official:** FAITH GASKINS (DIRECTOR OF CREDENTIALING)
- **Authorized official phone:** (972) 869-3789

## Contact information

- **Practice address:** 7449 E OSBORN RD STE 4, SCOTTSDALE, AZ 85251-6448
- **Practice address phone:** (480) 945-3723
- **Practice address fax:** (480) 945-2067
- **Mailing address:** 7449 E OSBORN RD STE 4, SCOTTSDALE, AZ 85251-6448
- **Mailing address phone:** (480) 945-3723
- **Mailing address fax:** (480) 945-2067

## Taxonomy

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

## Other

- **Enumeration date:** 01/05/2022
- **Last updated:** 01/05/2022