Provider Demographics
NPI:1659193852
Name:ARIZONA CENTER FOR ORAL SURGERY, PLC
Entity type:Organization
Organization Name:ARIZONA CENTER FOR ORAL SURGERY, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:HOAGLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:623-931-9197
Mailing Address - Street 1:18301 N 79TH AVE STE 185
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-6093
Mailing Address - Country:US
Mailing Address - Phone:623-931-9197
Mailing Address - Fax:623-937-4385
Practice Address - Street 1:18301 N 79TH AVE STE 185
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-6093
Practice Address - Country:US
Practice Address - Phone:623-931-9197
Practice Address - Fax:623-937-4385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty