Provider Demographics
NPI:1639189673
Name:SCAFARU, DANA (DDS)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:SCAFARU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6924 W DALE LN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-6669
Mailing Address - Country:US
Mailing Address - Phone:623-362-2339
Mailing Address - Fax:
Practice Address - Street 1:13540 W CAMINO DEL SOL
Practice Address - Street 2:SUITE #5
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-4434
Practice Address - Country:US
Practice Address - Phone:623-584-9833
Practice Address - Fax:623-584-9834
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ33361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice