Organization
DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM
Active
Parent organization
DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM
Other names
Salt River Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM
Authorized official
MISS DEANNA J. DICK MSW., MHA. ((CEO) CHIEF EXECUTIVE OFFICER)
(602) 263-1567
Entity
Organization
Contact information
Practice address
10005 E OSBORN RD, SCOTTSDALE, AZ 85256-4019
(602) 263-1200
(602) 263-1618
Mailing address
PO BOX 31001-0698, PASADENA, CA 91110-0698
(602) 263-1200
(602) 263-1618
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
092353
—
AZ
01
—
P0109880
BCBSAZ
AZ
Enumeration date
11/21/2006
Last updated
06/19/2019
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