Healthcare Provider Details

I. General information

NPI: 1639380678
Provider Name (Legal Business Name): CAREFREE DENTISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 09/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7518 ELBOW BEND SUITE A1
CAREFREE AZ
85377
US

IV. Provider business mailing address

PO BOX 2268
CAREFREE AZ
85377
US

V. Phone/Fax

Practice location:
  • Phone: 480-488-9735
  • Fax:
Mailing address:
  • Phone: 480-488-9735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SETH M JORGENSEN
Title or Position: CO-PRESIDENT
Credential: D.D.S.
Phone: 480-488-9735