Provider Demographics
NPI:1720295710
Name:DALE W. HARVEY, D.D.S., LTD
Entity Type:Organization
Organization Name:DALE W. HARVEY, D.D.S., LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BARB
Authorized Official - Middle Name:K
Authorized Official - Last Name:MEGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-931-2419
Mailing Address - Street 1:9035 N 43RD AVE STE B
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051-3265
Mailing Address - Country:US
Mailing Address - Phone:623-931-2419
Mailing Address - Fax:623-939-7913
Practice Address - Street 1:9035 N 43RD AVE STE B
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-3265
Practice Address - Country:US
Practice Address - Phone:623-931-2419
Practice Address - Fax:623-939-7913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty