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General NPI Number Information
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NPI Number | 1821939885
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Entity Type | Organization
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Legal Business Name | SOFLISA AZ, LLC
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Dates
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Enumeration Date | 04/03/2026
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Last Update Date | 04/03/2026
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Provider Practice Location Address
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Address Line | 6288 E GRANT RD
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City | TUCSON
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State | AZ
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Zip | 85712-5831
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Country | US
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Telephone | 520-214-2484
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Fax |
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Provider Business Mailing Address
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Address Line | 10741 165TH ST
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City | ORLAND PARK
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State | IL
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Zip | 60467-8713
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Country | US
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Telephone | 708-940-6190
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Fax | 708-364-2010
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Authorized Official
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Title or Position | OWNER/ DENTIST
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Name | DUAA HAMOUD
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Credential | DMD
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Telephone | 708-940-6190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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