Organization
CASAS ADOBES OMS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANIE DE MAINE (CREDENTIALING SPECIALIST)
(520) 745-6531
Entity
Organization
Contact information
Practice address
3150 N SWAN, TUCSON, AZ 85712
(520) 745-6531
(520) 790-3817
Mailing address
3150 N SWAN ROAD, TUCSON, AZ 85712
(520) 745-6531
(520) 790-3817
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
2774
AZ
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
—
Other
Enumeration date
07/10/2007
Last updated
04/13/2021
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