Provider Demographics
NPI:1447424460
Name:TODD H MABRY DDS PC
Entity Type:Organization
Organization Name:TODD H MABRY DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:H
Authorized Official - Last Name:MABRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-538-5210
Mailing Address - Street 1:8595 E BELL RD
Mailing Address - Street 2:SUITE D100
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260
Mailing Address - Country:US
Mailing Address - Phone:480-538-5210
Mailing Address - Fax:480-361-2905
Practice Address - Street 1:8595 E BELL RD
Practice Address - Street 2:SUITE D100
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260
Practice Address - Country:US
Practice Address - Phone:480-538-5210
Practice Address - Fax:480-361-2905
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TODD H MABRY DDS PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZD5322122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty