Organization
CONTINENTAL DENTAL CARE LLC
Active
Other names
Continental Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
RUBEN E VAZQUEZ (OWNER)
(623) 986-2606
Entity
Organization
Contact information
Practice address
5501 N 19TH AVE, SUITE 103, PHOENIX, AZ 85015-2450
(602) 864-1119
(602) 249-5080
Mailing address
5501 N 19TH AVE, SUITE 103, PHOENIX, AZ 85015-2450
(602) 864-1119
(602) 249-5080
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
F0213
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
965220
AHCCCS
AZ
Enumeration date
03/20/2006
Last updated
12/03/2009
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