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General NPI Number Information
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NPI Number | 1790563583
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Entity Type | Organization
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Legal Business Name | LABUZ DENTAL INC.
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Dates
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Enumeration Date | 09/21/2023
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Last Update Date | 09/21/2023
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Provider Practice Location Address
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Address Line | 1617 WESTCLIFF DR STE 201
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-5526
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Country | US
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Telephone | 949-642-7998
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Fax |
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Provider Business Mailing Address
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Address Line | 1617 WESTCLIFF DR STE 201
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-5526
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Country | US
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Telephone | 949-642-7998
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | PAULINA LABUZ
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Credential | DDS
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Telephone | 708-668-6709
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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