Provider Demographics
NPI:1063491306
Name:FARRAYE, ANTHONY RAYMOND (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:RAYMOND
Last Name:FARRAYE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10667 E DESERT COVE AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-3803
Mailing Address - Country:US
Mailing Address - Phone:480-661-9021
Mailing Address - Fax:
Practice Address - Street 1:2525 S RURAL RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-2435
Practice Address - Country:US
Practice Address - Phone:480-967-5788
Practice Address - Fax:480-967-3043
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ29591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice