Provider Demographics
NPI:1770009243
Name:BELLEZZA LLC
Entity Type:Organization
Organization Name:BELLEZZA LLC
Other - Org Name:SCOTTSDALE SKIN AND HOLISTIC HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:MAASS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-501-5087
Mailing Address - Street 1:39122 N 26TH ST
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331-0797
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7500 E PINNACLE PEAK RD STE A-207
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3406
Practice Address - Country:US
Practice Address - Phone:480-419-6996
Practice Address - Fax:480-419-6134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-16
Last Update Date:2017-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4134261QP2300X, 332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care