Provider Demographics
NPI:1780001800
Name:SCOTTSDALE DENTAL STUDIO
Entity Type:Organization
Organization Name:SCOTTSDALE DENTAL STUDIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MANPREET
Authorized Official - Middle Name:S
Authorized Official - Last Name:BADYAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-205-6961
Mailing Address - Street 1:5425 E BELL RD
Mailing Address - Street 2:SUITE #101
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-6007
Mailing Address - Country:US
Mailing Address - Phone:480-382-0337
Mailing Address - Fax:602-482-3824
Practice Address - Street 1:5425 E BELL RD
Practice Address - Street 2:SUITE #101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-6007
Practice Address - Country:US
Practice Address - Phone:480-382-0337
Practice Address - Fax:602-482-3824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-26
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD)5722261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental