Healthcare Provider Details

I. General information

NPI: 1730573361
Provider Name (Legal Business Name): DAGC SURGICAL ASSISTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2015
Last Update Date: 03/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 PISCIS CT
RIO RICO AZ
85648-2411
US

IV. Provider business mailing address

113 PISCIS CT
RIO RICO AZ
85648-2411
US

V. Phone/Fax

Practice location:
  • Phone: 888-322-6432
  • Fax: 888-329-6432
Mailing address:
  • Phone: 888-322-6432
  • Fax: 888-329-6432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name: MR. DIEGO A GARCIA
Title or Position: OWNER
Credential: CSFA
Phone: 520-988-2665