Core Family Dental

LBN: Core Family Dental
Core Family Dental is an health care organization with primary practice located at 13460 N 94Th Dr Ste K4 , Peoria AZ 85381-4249. The organization recently has only one registered license in Ambulatory Health Care Facilities / Dental, which is considered as the primary health care specialty. Core Family Dental can be contacted via phone (232) 231-0366, or through Jackson, Marvin Blane via phone (435) 637-2100.

Contact Information

Primary practice address
13460 N 94Th Dr Ste K4 Peoria AZ 85381-4249
Phone: (232) 231-0366
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Jackson, Marvin Blane Doctor of Dental Surgery (DDS)
Phone: (435) 637-2100

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Dental 261QD0000X

Profile Details

NPI number 1689283814
LBN Legal business name Core Family Dental
DBA Doing business as
Authorized official Jackson, Marvin Blane Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 23rd, 2020
Last updated Jul 28th, 2020 - about 4 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 1689283814 NPPES
Arizona MEDICAID 586868

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