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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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