Provider Demographics
NPI:1992713952
Name:BOCA, DAVID HENRY (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:HENRY
Last Name:BOCA
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 1:10214 N TATUM BLVD
Mailing Address - Street 2:A600
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028
Mailing Address - Country:US
Mailing Address - Phone:480-991-4727
Mailing Address - Fax:480-596-4087
Practice Address - Street 1:10214 N TATUM BLVD
Practice Address - Street 2:A600
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028
Practice Address - Country:US
Practice Address - Phone:480-991-4727
Practice Address - Fax:480-596-4087
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD3054122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist