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General NPI Number Information
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NPI Number | 1215661194
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Entity Type | Organization
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Legal Business Name | UNTVA PLLC
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Dates
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Enumeration Date | 07/15/2022
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Last Update Date | 07/15/2022
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Provider Practice Location Address
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Address Line | 15294 W BROOKSIDE LN STE 100
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City | SURPRISE
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State | AZ
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Zip | 85374-2446
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Country | US
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Telephone | 623-376-7400
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Fax |
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Provider Business Mailing Address
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Address Line | 15294 W BROOKSIDE LN STE 100
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City | SURPRISE
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State | AZ
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Zip | 85374-2446
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Country | US
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Telephone | 623-376-7400
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Fax |
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Authorized Official
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Title or Position | OWNER/ENDODONTIST
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Name | DR. ERIK JOHN FOISY
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Credential | DMD
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Telephone | 702-622-5123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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