Bradshaw Family Dental

LBN: Bradshaw Mountain Family Dental
Bradshaw Family Dental is an health care organization with primary practice located at 7136 Pav Way , Prescott Valley AZ 86314-2264. The organization recently has only one registered license in Managed Care Organizations / Preferred Provider Organization, which is considered as the primary health care specialty. Bradshaw Mountain Family Dental can be contacted via phone (928) 775-9495, or through Frausto, David via phone (928) 775-9495.

Contact Information

Primary practice address
7136 Pav Way Prescott Valley AZ 86314-2264
Phone: (928) 775-9495
Fax: (928) 775-9497
Website:
Map and Directions
Authorized official contact:
Name: Frausto, David Doctor of Dental Surgery (DDS)
Phone: (928) 775-9495

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Preferred Provider Organization 305R00000X

Profile Details

NPI number 1861855884
LBN Legal business name Bradshaw Mountain Family Dental
DBA Doing business as Bradshaw Family Dental
Authorized official Frausto, David Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 29th, 2016
Last updated Mar 29th, 2016 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861855884 NPPES
Arizona MEDICAID 722183

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