| NPI | 1861879066 |
|---|---|
| Doing Business As | SURPRISE DENTAL |
| Entity Type | Organization |
| Authorized Contact | KRYSTAL POWELL Revenue Cycle Director 623-583-3001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: AZ 1014823) |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2023-04-28 |