Provider Demographics
NPI:1225368798
Name:MICHAEL S. CAVENDER, DDS, PSC, INC
Entity Type:Organization
Organization Name:MICHAEL S. CAVENDER, DDS, PSC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:CAVENDER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-342-8118
Mailing Address - Street 1:9377 E BELL RD
Mailing Address - Street 2:#337
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-1502
Mailing Address - Country:US
Mailing Address - Phone:480-342-8118
Mailing Address - Fax:480-342-8131
Practice Address - Street 1:9377 E BELL RD
Practice Address - Street 2:#337
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-1502
Practice Address - Country:US
Practice Address - Phone:480-342-8118
Practice Address - Fax:480-342-8131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ68721223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty