MEDICARE: DENTAL CARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	AZ2021	AZ

General Provider Information

NPI Number	:	1417982059
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENTAL CARE INC

Provider Business Mailing Address
First Line	:	417 W CENTRAL AVENUE
Second Line	:	SUITE A
City	:	COOLIDGE
State	:	AZ
Zip	:	85228
Country	:	US
Telephone Number	:	520-723-1111
Fax Number	:	520-723-4186

Provider Business Practice Location Address
First Line	:	417 W CENTRAL AVENUE
Second Line	:	SUITE A
City	:	COOLIDGE
State	:	AZ
Zip	:	85228
Country	:	US
Telephone Number	:	520-723-1111
Fax Number	:	520-723-4186

Authorized Official
Title or Position	:	OFFICE MGR
Name	:	MRS. MERLINDA S SPEAMER
Credential	:
Telephone Number	:	520-723-1111

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	08/22/2020

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Directions to “DENTAL CARE INC ” Practice Location

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