| Banner Medical Group Dental Services Llc | |
|
1111 E Mcdowell Rd Phoenix AZ 85006-2612 | |
| (602) 839-2000 | |
| Not Available |
| Full Name | Banner Medical Group Dental Services Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1111 E Mcdowell Rd, Phoenix, Arizona |
| Authorized Official Name and Position | Dennis Dahlen (SR VP FINANCE) |
| Authorized Official Contact | 6027474000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Banner Medical Group Dental Services Llc 2901 N Central Ave Phoenix AZ 85012-2700 Ph: () - | Banner Medical Group Dental Services Llc 1111 E Mcdowell Rd Phoenix AZ 85006-2612 Ph: (602) 839-2000 |
| NPI Number | 1770953598 |
|---|---|
| Provider Enumeration Date | 10/06/2015 |
| Last Update Date | 10/06/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770953598 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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