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Organization
AZ OMS SPECIALTY DENTAL SERVICES, LLC
Active
Organization
AZ OMS SPECIALTY DENTAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE DASCH (DIRECTOR OF PROVIDER RELATIONS)
(504) 638-0303
Entity
Organization
Contact information
Practice address
1876 E INNOVATION PARK DR, ORO VALLEY, AZ 85755-1963
(520) 745-2454
Mailing address
1610 54TH AVE N STE 205, NASHVILLE, TN 37209-1442
(504) 638-0303
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
12/13/2021
Last updated
07/18/2023
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