Organization
BANNER PEDIATRIC SPECIALISTS LLC
Active
Organization
BANNER PEDIATRIC SPECIALISTS LLC
Active
Parent organization
BANNER HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANNER HEALTH
Authorized official
DENNIS DAHLEN (SR VP FINANCE)
(602) 747-4000
Entity
Organization
Contact information
Practice address
1432 S DOBSON RD, MESA, AZ 85202-4768
(480) 614-3665
Mailing address
1441 N 12TH ST, PHOENIX, AZ 85006-2837
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
11/06/2008
Last updated
04/17/2009
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