# CASAS ADOBES OMS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114125267
- **Authorized official:** JOANIE DE MAINE (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (520) 745-6531

## Contact information

- **Practice address:** 3150 N SWAN, TUCSON, AZ 85712
- **Practice address phone:** (520) 745-6531
- **Practice address fax:** (520) 790-3817
- **Mailing address:** 3150 N SWAN ROAD, TUCSON, AZ 85712
- **Mailing address phone:** (520) 745-6531
- **Mailing address fax:** (520) 790-3817

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | 2774 | AZ | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | NULL | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | — |

## Other

- **Enumeration date:** 07/10/2007
- **Last updated:** 04/13/2021