# NORTH VALLEY HEAD AND NECK SURGERY, LLC

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

## Provider details

- **NPI number:** 1770725913
- **Authorized official:** MR. GARY R. GROVER (SENIOR VICE PRESIDENT)
- **Authorized official phone:** (602) 216-6680

## Contact information

- **Practice address:** 9327 N 3RD ST, SUITE 202, PHOENIX, AZ 85020-2470
- **Practice address phone:** (602) 216-6686
- **Practice address fax:** (602) 216-6688
- **Mailing address:** PO BOX 9907, PHOENIX, AZ 85068-0907
- **Mailing address phone:** (602) 216-6686
- **Mailing address fax:** (602) 216-6688

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/02/2009
- **Last updated:** 04/02/2009