Provider Demographics
NPI:1861665242
Name:NORTHSTAR DENTAL P. C.
Entity Type:Organization
Organization Name:NORTHSTAR DENTAL P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:J
Authorized Official - Last Name:RIHANEK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:520-531-8207
Mailing Address - Street 1:12152 N RANCHO VISTOSO BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85755-1843
Mailing Address - Country:US
Mailing Address - Phone:520-531-8207
Mailing Address - Fax:520-531-8304
Practice Address - Street 1:12152 N RANCHO VISTOSO BLVD STE 120
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85755-1843
Practice Address - Country:US
Practice Address - Phone:520-531-8207
Practice Address - Fax:520-531-8304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD45841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty