# SAN CARLOS APACHE HEALTHCARE CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SAN CARLOS APACHE HEALTHCARE CORPORATION
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1356790059
- **Legal business name:** SAN CARLOS APACHE HEALTHCARE CORPORATION
- **Authorized official:** VICTORIA BEGAN (INTERIM CEO)
- **Authorized official phone:** (928) 475-1200

## Contact information

- **Practice address:** 103 MEDICINE WAY ROAD, PERIDOT, AZ 85542
- **Practice address phone:** (928) 475-1200
- **Mailing address:** PO BOX 787, PERIDOT, AZ 85542-0787

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 06/03/2016
- **Last updated:** 06/03/2016