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General NPI Number Information
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NPI Number | 1740253806
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Entity Type | Individual
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Provider Name | LUZ DEPANTE TOBIAS DDS
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Gender | Female
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Dates
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Enumeration Date | 02/09/2006
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Last Update Date | 04/11/2011
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Provider Practice Location Address
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Address Line | 303 E BASELINE RD STE 201
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City | PHOENIX
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State | AZ
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Zip | 85042-6575
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Country | US
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Telephone | 602-276-1995
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Fax | 602-276-1918
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Provider Business Mailing Address
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Address Line | 303 E BASELINE RD STE 201
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City | PHOENIX
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State | AZ
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Zip | 85042-6575
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Country | US
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Telephone | 602-276-1995
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Fax | 602-276-1918
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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 | D5366
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License Number State | AZ
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