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General NPI Number Information
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NPI Number | 1720107600
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Entity Type | Organization
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Legal Business Name | DR. GREG CEYHAN DDS, PLLC
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 12/11/2008
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Provider Practice Location Address
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Address Line | 17100 N 67TH AVE. SUITE 500
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City | GLENDALE
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State | AZ
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Zip | 85308
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Country | US
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Telephone | 623-979-1515
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Fax |
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Provider Business Mailing Address
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Address Line | 17100 N 67TH AVE STE 500
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City | GLENDALE
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State | AZ
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Zip | 85308-3699
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Country | US
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Telephone | 623-979-1515
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. GREG CEYHAN
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Credential | DDS
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Telephone | 623-979-1515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 5333
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License Number State | AZ
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