Provider Demographics
NPI:1376249938
Name:AZIZ BOHRA, DDS, PLC
Entity Type:Organization
Organization Name:AZIZ BOHRA, DDS, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:AZIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:BOHRA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:623-556-1294
Mailing Address - Street 1:18731 N. REEMS ROAD
Mailing Address - Street 2:SUITE # F620
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374
Mailing Address - Country:US
Mailing Address - Phone:623-556-1294
Mailing Address - Fax:623-556-2965
Practice Address - Street 1:18731 N. REEMS ROAD
Practice Address - Street 2:SUITE # F620
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374
Practice Address - Country:US
Practice Address - Phone:623-556-1294
Practice Address - Fax:623-556-2965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty