Organization · NPI-2

Arizona Healthcare Outreach

Clinic/Center, Dental · Phoenix, AZ

NPI number1699307306

StatusActive

Last updated in NPPESFeb 10, 2020

Details

NPI: 1699307306
Entity type: Organization (NPI-2)
Legal business name: Arizona Healthcare Outreach
Organization subpart: No
Enumeration date: Feb 10, 2020
Certification date: Feb 10, 2020
Last updated: Feb 10, 2020

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
261QD0000X	Clinic/Center, Dental	–	–	Yes
251K00000X	Public Health or Welfare	–	–
251V00000X	Voluntary or Charitable	–	–
261Q00000X	Clinic/Center	–	–
261QH0100X	Clinic/Center, Health Services	–	–
261QM1000X	Clinic/Center, Migrant Health	–	–
261QP0905X	Clinic/Center, Public Health, State or Local	–	–
261QS0112X	Clinic/Center, Oral and Maxillofacial Surgery	–	–

Practice location

3581 W Northern Ave Ste 8
Phoenix, AZ 85051-9404

Phone 480-830-9555 · Fax 480-499-0083

Mailing address

4037 E Garnet Cir
Mesa, AZ 85206-3266

Phone 480-830-9555 · Fax 480-499-0083

Authorized official

Collette Barr
Director
4808309555

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