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General NPI Number Information
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NPI Number | 1669728150
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Entity Type | Organization
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Legal Business Name | LUX COZY DENTAL SPA
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Dates
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Enumeration Date | 08/02/2012
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Last Update Date | 08/02/2012
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Provider Practice Location Address
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Address Line | 34597 N. 60TH ST. #101
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City | SCOTTSDALE
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State | AZ
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Zip | 85266
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Country | US
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Telephone | 480-488-9655
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Fax | 480-575-1130
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Provider Business Mailing Address
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Address Line | 34597 N. 60TH ST. #101
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City | SCOTTSDALE
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State | AZ
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Zip | 85266
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Country | US
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Telephone | 480-488-9655
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Fax | 480-575-1130
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. KEVIN CHO
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Credential |
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Telephone | 480-488-9655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D008445
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License Number State | AZ
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