Organization
ADELANTE HEALTHCARE INC
Active
Other names
Surprise Dental
Organization subpart
No
Provider details
NPI number
Authorized official
KRYSTAL POWELL (REVENUE CYCLE DIRECTOR)
(623) 583-3001
Entity
Organization
Contact information
Practice address
15317 W BELL RD STE 108, SURPRISE, AZ 85374-3901
(480) 964-2273
(623) 214-5213
Mailing address
3033 N CENTRAL AVE STE 145, PHOENIX, AZ 85012-2808
(623) 583-3001
(623) 876-9559
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
1014823
AZ
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
04/27/2015
Last updated
04/28/2023
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