Provider Demographics
NPI:1710192760
Name:SAGUARO FAMILY DENTISTRY
Entity Type:Organization
Organization Name:SAGUARO FAMILY DENTISTRY
Other - Org Name:SIGNATURE SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-483-1355
Mailing Address - Street 1:9813 N 95TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4544
Mailing Address - Country:US
Mailing Address - Phone:480-483-1355
Mailing Address - Fax:480-483-0904
Practice Address - Street 1:9813 N 95TH ST STE 101
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4544
Practice Address - Country:US
Practice Address - Phone:480-483-1355
Practice Address - Fax:480-483-0904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4079122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty