Organization
DESERT FOUNTAIN MEDICAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRANT ANDRES (CLINIC DIRECTOR)
(480) 816-8300
Entity
Organization
Contact information
Practice address
17100 E SHEA BLVD STE 320, FOUNTAIN HILLS, AZ 85268-6654
(480) 816-8300
Mailing address
17100 E SHEA BLVD STE 320, FOUNTAIN HILLS, AZ 85268-6654
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
01/02/2018
Last updated
01/02/2018
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