Provider Demographics
NPI:1639361306
Name:POLLARD, EKATERINA N (DDS)
Entity Type:Individual
Prefix:
First Name:EKATERINA
Middle Name:N
Last Name:POLLARD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:EKATERINA
Other - Middle Name:N
Other - Last Name:GONCHAROVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:9332 E WOOD DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-7407
Mailing Address - Country:US
Mailing Address - Phone:602-308-9391
Mailing Address - Fax:
Practice Address - Street 1:9332 E WOOD DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-7407
Practice Address - Country:US
Practice Address - Phone:602-308-9391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD58081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice