Individual provider · NPI-1

Mark Abzug

Dentist, General Practice · Phoenix, AZ

NPI number1871648543
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1871648543
Entity type
Individual (NPI-1)
Name
Mark Abzug
Sex
Male
Sole proprietor
Yes
Enumeration date
Jan 24, 2007
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice2576AZYes

Practice location

11110 N Tatum Blvd
Suite 102
Phoenix, AZ 85028-1607

Phone 602-977-1110

Mailing address

11110 N Tatum Blvd
Suite 102
Phoenix, AZ 85028-1607

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