Organization
JOHN BRAVO DACANAY MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN B DACANAY (OWNER)
(928) 474-9744
Entity
Organization
Contact information
Practice address
120 E MAIN ST, SUITE A, PAYSON, AZ 85541-5618
(928) 474-9744
Mailing address
120 E MAIN ST, SUITE A, PAYSON, AZ 85541-5618
(928) 474-9744
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
37784
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
AZ
Enumeration date
02/21/2008
Last updated
02/21/2008
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