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General NPI Number Information
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NPI Number | 1679914337
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Entity Type | Individual
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Provider Name | ANTHONY GEORGE MIAOULIS DMD
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Gender | Male
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Dates
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Enumeration Date | 07/10/2013
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Last Update Date | 07/20/2018
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Provider Practice Location Address
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Address Line | 11015 N SCOTTSDALE RD STE 101
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City | SCOTTSDALE
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State | AZ
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Zip | 85254
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Country | US
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Telephone | 480-544-2800
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Fax | 480-544-1148
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Provider Business Mailing Address
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Address Line | 19637 N 15TH PL
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City | PHOENIX
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State | AZ
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Zip | 85024-3647
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Country | US
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Telephone | 480-747-4417
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | D008724
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License Number State | AZ
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