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Provider Information for 1932321130



DR. KAMRAN FATTAH DMD

Gender: MALE

Individual NPI: 1932321130

Calendar Last Updated: 2017-12-08

Details

Name Value
NPI 1932321130
Enumeration Date 2007-05-03
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 8055 N VIA DE NEGOCIO
SCOTTSDALE, AZ 85258-4313
United States

Phone: 480-607-6937 | Fax: 480-607-6973
View Map External Link
Primary Practice Address 8055 N VIA DE NEGOCIO
SCOTTSDALE, AZ 85258-4313
United States

Phone: 480-607-6937 | Fax: 480-607-6973
View Map External Link
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice AZ D009597
No 1223G0001X - Dentist General Practice OR D8308
Other Identifiers
Issuer State Number
Endpoint Information
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location