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General NPI Number Information
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NPI Number | 1659193852
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Entity Type | Organization
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Legal Business Name | ARIZONA CENTER FOR ORAL SURGERY, PLC
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Dates
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Enumeration Date | 10/29/2024
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 18301 N 79TH AVE STE 185
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City | GLENDALE
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State | AZ
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Zip | 85308-6093
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Country | US
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Telephone | 623-931-9197
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Fax | 623-937-4385
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Provider Business Mailing Address
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Address Line | 18301 N 79TH AVE STE 185
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City | GLENDALE
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State | AZ
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Zip | 85308-6093
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Country | US
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Telephone | 623-931-9197
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Fax | 623-937-4385
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Authorized Official
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Title or Position | PARTNER
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Name | DR. DONALD HOAGLIN
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Credential | DDS
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Telephone | 623-931-9197
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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