| Community Dental Services Of Az | |
|
201 S 36th St Phoenix AZ 85034 | |
| (602) 434-8699 | |
| (602) 391-2380 |
| Full Name | Community Dental Services Of Az |
|---|---|
| Speciality | Dentist |
| Location | 201 S 36th St, Phoenix, Arizona |
| Authorized Official Name and Position | Elizabeth Loelke (VICE PRESIDENT) |
| Authorized Official Contact | 6024348699 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Dental Services Of Az 201 S 36th St Phoenix AZ 85034 Ph: (602) 434-8699 | Community Dental Services Of Az 201 S 36th St Phoenix AZ 85034 Ph: (602) 434-8699 |
| NPI Number | 1548320609 |
|---|---|
| Provider Enumeration Date | 12/11/2006 |
| Last Update Date | 02/20/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548320609 | NPI | - | NPPES |
| 161168 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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