| Children's Dental Clinic Of Tucson, Llc | |
|
910 W Irvington Rd #180 Tucson AZ 85714-2458 | |
| (520) 806-0120 | |
| Not Available |
| Full Name | Children's Dental Clinic Of Tucson, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 910 W Irvington Rd, Tucson, Arizona |
| Authorized Official Name and Position | Trudy Williams (DIRECTOR, LICENSING & CREDENTIALING) |
| Authorized Official Contact | 6157500342 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Dental Clinic Of Tucson, Llc 201 W 8th St Suite 810 Pueblo CO 81003-3038 Ph: (719) 562-4447 | Children's Dental Clinic Of Tucson, Llc 910 W Irvington Rd #180 Tucson AZ 85714-2458 Ph: (520) 806-0120 |
| NPI Number | 1861406829 |
|---|---|
| Provider Enumeration Date | 07/27/2006 |
| Last Update Date | 05/17/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861406829 | NPI | - | NPPES |
| 736267 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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