Individual
DR. TINISHA NOTICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS, MS
Contact information
Practice address
11015 N SCOTTSDALE RD STE 101, SCOTTSDALE, AZ 85254-5196
(480) 544-2800
Mailing address
3557 E TINA DR, PHOENIX, AZ 85050-0091
(909) 455-6984
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
D009689
AZ
1223P0300X
Periodontics
Primary
D009689
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2016
Last updated
08/24/2021
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