Organization
DHHS-PHS, IHS TUCSON AREA, IHS TUCSON
Active
Other names
SELLS INDIAN HOSPITAL DENTAL
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KURT PRIESSMAN B.A., M.B.A., C.P.M. (ACCOUNTING AND BUDGET OFFICER)
(520) 295-2427
Entity
Organization
Contact information
Practice address
HIGHWAY 86 AND TOPAWA ROAD, SELLS, AZ 85634
(520) 383-7251
(520) 383-7216
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
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004101-03
—
AZ
01
—
0325642
NACADP #
AZ
01
—
1487652426
FACILITY NPI #
AZ
01
—
1558344358
DENTAL NPI #
AZ
01
—
AZ0209610
BC/BSAZ DENTAL PROV NO
AZ
Enumeration date
11/25/2005
Last updated
01/15/2008
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