Organization
DESERT DENTAL GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLY HAMPTON (OFFICE MANAGER)
(520) 663-0419
Entity
Organization
Contact information
Practice address
8265 S HOUGHTON RD, SUITE 101, TUCSON, AZ 85747-9702
(520) 663-0419
(520) 663-0429
Mailing address
8265 S HOUGHTON RD, SUITE 101, TUCSON, AZ 85747-9702
(520) 663-0419
(520) 663-0429
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5038
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100-5038
DELTA DENTAL
AZ
01
—
AZ 0490680
BLUECROSS BLUESHIELD
AZ
Enumeration date
10/17/2007
Last updated
09/27/2013
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