| Dhhs Ihs Phoenix Area | |
|
North Cromwell Road Cibecue AZ 85911 | |
| (928) 332-2560 | |
| (928) 338-5508 |
| Full Name | Dhhs Ihs Phoenix Area |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | North Cromwell Road, Cibecue, Arizona |
| Authorized Official Name and Position | Michelle Martinez (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9283384911 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dhhs Ihs Phoenix Area P.o. Box 860 200 Hospital Drive Whiteriver AZ 85941-0860 Ph: (928) 338-4911 | Dhhs Ihs Phoenix Area North Cromwell Road Cibecue AZ 85911 Ph: (928) 332-2560 |
| NPI Number | 1184874034 |
|---|---|
| Provider Enumeration Date | 09/29/2008 |
| Last Update Date | 03/27/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184874034 | NPI | - | NPPES |
| 092461 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |