National Provider Identifier Database

MOUNTAIN PARK HEALTH CENTER DENTAL
Federally Qualified Health Center (FQHC)

A Federally Qualified Health Center (FQHC) is a community-based organization that provides comprehensive primary care and preventive care, including health, oral, and mental health/substance abuse services to persons of all ages, regardless of their ability to pay or health insurance status.


Contact Information

MOUNTAIN PARK HEALTH CENTER - DENTAL
635 E BASELINE RD
PHOENIX, AZ85042-6551
Phone: 602-243-7277
Fax: 602-323-3299
Website:
Specialty Taxonomy Code
* Federally Qualified Health Center (FQHC) 261QF0400X

* Indicates primary specialty

NPI Profile & details for MOUNTAIN PARK HEALTH CENTER - DENTAL

NPI Number 1710146188
Legal business name
LBN
MOUNTAIN PARK HEALTH CENTER - DENTAL
Authorized official JOHN SWAGERT - (PRESIDENT & CEO)
Entity Organization
Organization subpart Yes
Enumeration date 06/02/2008
Last updated 03/13/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers
  • AZ License #: OTC0599

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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