Organization
DHHS-PHS, IHS TUCSON AREA, IHS TUCSON SANTA ROSA CLINIC
Active
Other names
SANTA ROSA DENTAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KURT PRIESSMAN M.A., M.B.A., C.P.M. (ACCOUNTING AND BUDGET OFFICER)
(520) 295-2427
Entity
Organization
Contact information
Practice address
FEDERAL ROUTE 15, SANTA ROSA VILLAGE, AZ 85634
(520) 383-5570
(520) 383-5572
Mailing address
7900 S J STOCK RD, TUCSON, AZ 85746-7012
(520) 295-2427
(520) 295-2611
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0327177
NACADP#
AZ
01
—
1073502506
PHARMACY PROV NO
AZ
05
—
147141-03
—
AZ
01
—
1770581639
FACILITY PROVIDER #
AZ
01
—
AZ0209590
BC/BSAZ DENTAL PROV NO
AZ
01
—
AZ0209630
BC/BSAZ PROV NO
AZ
Enumeration date
12/14/2005
Last updated
09/11/2025
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