Provider Demographics
NPI:1518344910
Name:CDC GROUP INC
Entity Type:Organization
Organization Name:CDC GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-941-7070
Mailing Address - Street 1:7700 E INDIAN SCHOOL RD STE 3
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-4043
Mailing Address - Country:US
Mailing Address - Phone:480-941-7070
Mailing Address - Fax:480-941-0067
Practice Address - Street 1:7700 E INDIAN SCHOOL RD STE 3
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-4043
Practice Address - Country:US
Practice Address - Phone:480-941-7070
Practice Address - Fax:480-941-0067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-05
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD7163122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty