Organization
DESERT FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT RYAN LEE DDS (OWNER)
(480) 838-4185
Entity
Organization
Contact information
Practice address
1911 W MAIN ST, #6, MESA, AZ 85201-6929
(480) 838-4185
(480) 838-8746
Mailing address
1911 W MAIN ST, #6, MESA, AZ 85201-6929
(480) 838-4185
(480) 838-8746
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7570
AZ
122300000X
Dentist
8303
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003195413
DENTIST
AZ
01
—
1427213172
DENTIST
AZ
Enumeration date
10/25/2013
Last updated
10/25/2013
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