Coolidge Family Dental | |
1427 N Arizona Blvd Coolidge AZ 85128-3214 | |
(520) 723-1700 | |
(520) 723-1702 |
Full Name | Coolidge Family Dental |
---|---|
Speciality | Dentist - General Practice |
Location | 1427 N Arizona Blvd, Coolidge, Arizona |
Authorized Official Name and Position | Christopher Anthony Ballew (OWNER) |
Authorized Official Contact | 5207231700 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Coolidge Family Dental 1427 N Arizona Blvd Coolidge AZ 85128-3214 Ph: (520) 723-1700 | Coolidge Family Dental 1427 N Arizona Blvd Coolidge AZ 85128-3214 Ph: (520) 723-1700 |
NPI Number | 1154798064 |
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Provider Enumeration Date | 08/26/2015 |
Last Update Date | 08/26/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154798064 | NPI | - | NPPES |
1134383631 | Other | AZ | PROVIDER NPI |
D07579 | Other | AZ | DENTAL LICENCE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | D07579 (Arizona) | Primary |
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Coolidge Family Dental Care Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1427 N Arizona Blvd, Coolidge, AZ 85128 Phone: 520-723-1700 Fax: 520-723-1702 |