Healthcare Provider Details

I. General information

NPI: 1215405949
Provider Name (Legal Business Name): DENNY CLINICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2018
Last Update Date: 11/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

661 E HOWARDS RD STE B2
CAMP VERDE AZ
86322-6521
US

IV. Provider business mailing address

1430 N EAGLE VIEW DR
COTTONWOOD AZ
86326-6133
US

V. Phone/Fax

Practice location:
  • Phone: 406-570-3908
  • Fax:
Mailing address:
  • Phone: 406-570-3908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID BEN DENNY
Title or Position: PSYCHOLOGIST
Credential: PSYD
Phone: 405-570-3908