| NPI | 1346282076 |
|---|---|
| Former Legal Business Name | JOHN C LINCOLN LLC |
| Doing Business As | DYNAMITE CREEK MEDICAL CENTER |
| Entity Type | Organization |
| Authorized Contact | SAVAS PETRIDES SVP/CEO 480-696-4020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ Group NPI) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2020-09-17 |