MEDICARE: DENTAL PRIDE

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	1223G0001X	General Practice Dentistry	6796	AZ

General Provider Information

NPI Number	:	1497771877
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENTAL PRIDE

Provider Business Mailing Address
First Line	:	899 N WILMOT RD STE B1
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85711-1712
Country	:	US
Telephone Number	:	520-745-1001
Fax Number	:	520-745-1004

Provider Business Practice Location Address
First Line	:	899 N WILMOT RD STE B1
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85711-1712
Country	:	US
Telephone Number	:	520-745-1001
Fax Number	:	520-745-1004

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. LORI ANN GAFFNEY
Credential	:
Telephone Number	:	520-745-1001

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1053923912 — JULIE KOTELMAN DNP, PMHNP-BC
Practice Location Address:

899 N WILMOT RD STE B
TUCSON, AZ
85711-1712

Practice Phone: 520-290-1100
Practice Fax: 520-290-8997

1699778134 — MR. SANTSINGH KHALSA M.D.
Practice Location Address:

899 N WILMOT RD , STE C2
TUCSON, AZ
85711-1712

Practice Phone: 520-745-6946
Practice Fax: 520-747-2454

1801869219 — DR. WALID NADER MD
Practice Location Address:

899 N WILMOT RD STE B
TUCSON, AZ
85711-1712

Practice Phone: 520-290-1100
Practice Fax: 520-290-8997

1891764544 — MARY ANN CLENDENIN LCSW
Practice Location Address:

899 N WILMOT RD STE B
TUCSON, AZ
85711-1712

Practice Phone: 520-290-1100
Practice Fax: 520-290-8997

1346256252 — DR. RODNEY JENE GOLD DDS
Practice Location Address:

899 N WILMOT , STE A-2
TUCSON, AZ
85711-1712

Practice Phone: 520-790-9100
Practice Fax: 520-790-0809

1144331729 — MR. SEAN WILLIAM ELLINGTON L.P.C.
Practice Location Address:

899 N WILMOT RD STE B
TUCSON, AZ
85711-1712

Practice Phone: 520-290-1100
Practice Fax: 520-290-8997

Directions to “DENTAL PRIDE ” Practice Location

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