Provider Demographics
NPI:1437217882
Name:ARZU, LUIS A (DDS)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:A
Last Name:ARZU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:LUIS
Other - Middle Name:ADOLFO
Other - Last Name:ARZU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3722 W FULLERTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-2306
Mailing Address - Country:US
Mailing Address - Phone:773-486-8787
Mailing Address - Fax:773-486-8955
Practice Address - Street 1:3722 W FULLERTON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-2306
Practice Address - Country:US
Practice Address - Phone:773-486-8787
Practice Address - Fax:773-486-8955
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist