Organization
AZ OMS SPECIALTY DENTAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE DASCH (DIRECTOR OF PROVIDER RELATIONS)
(504) 638-0303
Entity
Organization
Contact information
Practice address
1876 E INNOVATION PARK DR, ORO VALLEY, AZ 85755-1963
(520) 745-2454
Mailing address
1610 54TH AVE N STE 205, NASHVILLE, TN 37209-1442
(504) 638-0303
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
12/13/2021
Last updated
07/18/2023
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