Provider Demographics
NPI:1841216090
Name:SONORAN DENTAL DESIGN
Entity Type:Organization
Organization Name:SONORAN DENTAL DESIGN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIELICKI-HALMEKANGAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-585-7560
Mailing Address - Street 1:7500 E PINNACLE PEAK RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-3406
Mailing Address - Country:US
Mailing Address - Phone:480-419-9595
Mailing Address - Fax:480-419-7417
Practice Address - Street 1:7500 E PINNACLE PEAK RD
Practice Address - Street 2:204
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3406
Practice Address - Country:US
Practice Address - Phone:480-419-9595
Practice Address - Fax:480-419-7417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty