Organization
BANNER -- UNIVERSITY DENTAL SERVICES LLC
Active
Parent organization
BANNER UNIVERSITY MEDICAL GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANNER UNIVERSITY MEDICAL GROUP
Authorized official
DENNIS DAHLEN (SR VP FINANCE)
(602) 747-4000
Entity
Organization
Contact information
Practice address
1111 E MCDOWELL RD, PHOENIX, AZ 85006-2612
(602) 839-2000
Mailing address
2901 N CENTRAL AVE, PHOENIX, AZ 85012-2700
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/06/2015
Last updated
10/06/2015
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