| Arizona Department Of Health Services, Office Of Oral Health | |
|
1740 W Adams St Rm 205 Phoenix AZ 85007-2607 | |
| (602) 542-1866 | |
| (602) 542-2936 |
| Full Name | Arizona Department Of Health Services, Office Of Oral Health |
|---|---|
| Speciality | Dentist - Dental Public Health |
| Location | 1740 W Adams St, Phoenix, Arizona |
| Authorized Official Name and Position | Patricia A. Price (SEALANT PROGRAM MANAGER) |
| Authorized Official Contact | 6025421891 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Arizona Department Of Health Services, Office Of Oral Health 1740 W Adams St Rm 205 Phoenix AZ 85007-2607 Ph: (602) 542-1866 | Arizona Department Of Health Services, Office Of Oral Health 1740 W Adams St Rm 205 Phoenix AZ 85007-2607 Ph: (602) 542-1866 |
| NPI Number | 1336275833 |
|---|---|
| Provider Enumeration Date | 02/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336275833 | NPI | - | NPPES |
| 703886 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0001X | Dentist - Dental Public Health | (Arizona) | Primary |
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