Organization
SUN LIFE FAMILY HEALTH CENTER, INC.
Active
Other names
Sun Life Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
TRAVIS J ROBINETTE (CHIEF EXECUTIVE OFFICER)
(520) 836-3446
Entity
Organization
Contact information
Practice address
1864 E FLORENCE BLVD, SUITE1, CASA GRANDE, AZ 85122-5457
(520) 836-3446
(520) 836-8807
Mailing address
PO BOX 10097, CASA GRANDE, AZ 85130-0020
(520) 836-3446
(520) 836-8807
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
BL-16-58324
AZ
Other
Enumeration date
03/14/2016
Last updated
08/03/2017
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