Provider Demographics
NPI:1154698876
Name:MIGLIAZZO, LOUIS (DDS)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:
Last Name:MIGLIAZZO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2544 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-4746
Mailing Address - Country:US
Mailing Address - Phone:520-323-7550
Mailing Address - Fax:
Practice Address - Street 1:2544 E 10TH ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-4746
Practice Address - Country:US
Practice Address - Phone:520-323-7550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD3553122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist