Provider Demographics
NPI:1417213315
Name:AZD BELL LLC
Entity Type:Organization
Organization Name:AZD BELL LLC
Other - Org Name:ARTISTIC DESIGN FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-563-0525
Mailing Address - Street 1:9377 E BELL RD
Mailing Address - Street 2:#347
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-1502
Mailing Address - Country:US
Mailing Address - Phone:480-563-0525
Mailing Address - Fax:
Practice Address - Street 1:9377 E BELL RD
Practice Address - Street 2:#347
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-1502
Practice Address - Country:US
Practice Address - Phone:480-563-0525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENDEAVOR DENTAL GROUP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ82201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty