Provider Demographics
NPI:1114031077
Name:PRICE, DAVID WAYNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WAYNE
Last Name:PRICE
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 1:5620 W THUNDERBIRD ROAD
Mailing Address - Street 2:SUITE H-4
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-4653
Mailing Address - Country:US
Mailing Address - Phone:602-439-1501
Mailing Address - Fax:602-439-1641
Practice Address - Street 1:5620 W THUNDERBIRD ROAD
Practice Address - Street 2:SUITE H-4
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4653
Practice Address - Country:US
Practice Address - Phone:602-439-1501
Practice Address - Fax:602-439-1641
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ26661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice