Provider Demographics
NPI:1679717508
Name:DONOHO DENTAL ASSOCIATES, PC
Entity type:Organization
Organization Name:DONOHO DENTAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:DONOHO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:623-977-8323
Mailing Address - Street 1:10503 W THUNDERBIRD BLVD
Mailing Address - Street 2:#384
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-3022
Mailing Address - Country:US
Mailing Address - Phone:623-977-8323
Mailing Address - Fax:
Practice Address - Street 1:10503 W THUNDERBIRD BLVD
Practice Address - Street 2:#384
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3022
Practice Address - Country:US
Practice Address - Phone:623-977-8323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-22
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ36931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty