Provider Demographics
NPI:1497000764
Name:GAFNI, TAL SHLOMO (DMD)
Entity Type:Individual
Prefix:DR
First Name:TAL
Middle Name:SHLOMO
Last Name:GAFNI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7904 E VISTA DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-7640
Mailing Address - Country:US
Mailing Address - Phone:602-432-4250
Mailing Address - Fax:
Practice Address - Street 1:3607 E BELL RD STE 5
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2152
Practice Address - Country:US
Practice Address - Phone:602-482-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ454080071122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist