Provider Demographics
NPI:1376780817
Name:MCCAFFREY, GARTH BLAIR (DDS)
Entity Type:Individual
Prefix:DR
First Name:GARTH
Middle Name:BLAIR
Last Name:MCCAFFREY
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 1:38840 N SPUR CROSS RD
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331-8505
Mailing Address - Country:US
Mailing Address - Phone:239-682-2865
Mailing Address - Fax:
Practice Address - Street 1:10503 W THUNDERBIRD BLVD STE 371
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-2721
Practice Address - Country:US
Practice Address - Phone:239-682-2865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-20
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN16993122300000X
AZD009676122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist