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General NPI Number Information
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NPI Number | 1215910484
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Entity Type | Organization
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Legal Business Name | DHHS-PHS, IHS TUCSON AREA, IHS TUCSON
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Dates
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Enumeration Date | 11/22/2005
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 7900 S J STOCK RD
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City | TUCSON
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State | AZ
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Zip | 85746-7012
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Country | US
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Telephone | 520-295-2575
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Fax | 520-295-2574
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Provider Business Mailing Address
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Address Line | 7900 S J STOCK RD
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City | TUCSON
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State | AZ
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Zip | 85746-7012
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Country | US
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Telephone | 520-295-2503
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Fax | 520-295-2676
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Authorized Official
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Title or Position | BUDGET ANALYST
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Name | MS. ARLENE RAYMOND
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Credential |
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Telephone | 520-295-2427
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 126800000X
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Taxonomy Name | Dental Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number |
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License Number State |
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