Provider Demographics
NPI:1215405949
Name:DENNY CLINICAL SERVICES LLC
Entity Type:Organization
Organization Name:DENNY CLINICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:BEN
Authorized Official - Last Name:DENNY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:405-570-3908
Mailing Address - Street 1:1430 N EAGLE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-6133
Mailing Address - Country:US
Mailing Address - Phone:406-570-3908
Mailing Address - Fax:
Practice Address - Street 1:661 E HOWARDS RD STE B2
Practice Address - Street 2:
Practice Address - City:CAMP VERDE
Practice Address - State:AZ
Practice Address - Zip Code:86322-6521
Practice Address - Country:US
Practice Address - Phone:406-570-3908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-12
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health