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General NPI Number Information
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NPI Number | 1962447185
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Entity Type | Organization
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Legal Business Name | UNION HILLS SURGERY CENTER
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 18301 N 79TH AVE STE E150
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City | GLENDALE
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State | AZ
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Zip | 85308-6045
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Country | US
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Telephone | 623-487-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 1441 N 12TH ST
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City | PHOENIX
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State | AZ
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Zip | 85006-2837
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SYSTEM MANAGER
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Name | DENNIS DAHLEN
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Credential |
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Telephone | 602-747-4577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | OSC 3777
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License Number State | AZ
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