Provider Demographics
NPI:1255972295
Name:ARIZONA DENTAL HEALTH PARTNERS LLC
Entity type:Organization
Organization Name:ARIZONA DENTAL HEALTH PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARINIC
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-775-5120
Mailing Address - Street 1:3134 W CAREFREE HWY STE 9
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-4001
Mailing Address - Country:US
Mailing Address - Phone:602-775-5120
Mailing Address - Fax:
Practice Address - Street 1:3134 W CAREFREE HWY STE 9
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85086-4001
Practice Address - Country:US
Practice Address - Phone:602-775-5120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-01
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies