Provider Demographics
NPI:1386883692
Name:DESERT MOUNTAIN SURGERY CENTER, P.L.C.
Entity type:Organization
Organization Name:DESERT MOUNTAIN SURGERY CENTER, P.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:CREECH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-899-3737
Mailing Address - Street 1:895 S DOBSON RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-5718
Mailing Address - Country:US
Mailing Address - Phone:480-899-3737
Mailing Address - Fax:
Practice Address - Street 1:895 S DOBSON RD
Practice Address - Street 2:SUITE 3
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5718
Practice Address - Country:US
Practice Address - Phone:480-899-0110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DESERT MOUNTAIN PLASTIC SURGEONS PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOSC4418261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical