Provider Demographics
NPI:1598216079
Name:ARIZONA DENTAL CENTER PLLC
Entity type:Organization
Organization Name:ARIZONA DENTAL CENTER PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:RYFF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-991-2180
Mailing Address - Street 1:5410 N SCOTTSDALE RD STE D500
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-5941
Mailing Address - Country:US
Mailing Address - Phone:480-991-2180
Mailing Address - Fax:
Practice Address - Street 1:5410 N SCOTTSDALE RD STE D500
Practice Address - Street 2:
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-5941
Practice Address - Country:US
Practice Address - Phone:480-991-2180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-19
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD81921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty