| Leupp Dental | |
|
1.5 Mile N Of Leupp Chapter House Leupp AZ 86032 | |
| (928) 686-6554 | |
| (928) 686-6566 |
| Full Name | Leupp Dental |
|---|---|
| Speciality | Clinic/center |
| Location | 1.5 Mile N Of Leupp Chapter House, Leupp, Arizona |
| Authorized Official Name and Position | Thomas Barnes (CHIEF OF DENTAL) |
| Authorized Official Contact | 9282894646 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leupp Dental Po Box 400 Winslow AZ 86047-0400 Ph: (928) 686-6554 | Leupp Dental 1.5 Mile N Of Leupp Chapter House Leupp AZ 86032 Ph: (928) 686-6554 |
| NPI Number | 1497925218 |
|---|---|
| Provider Enumeration Date | 03/07/2008 |
| Last Update Date | 10/10/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497925218 | NPI | - | NPPES |
| 758526 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Arizona) | Primary |
Leupp Health Station Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1.5 Mile N Of Leupp Chapter House, Leupp, AZ 86035 Phone: 928-289-4646 Fax: 928-289-6290 |