Provider Demographics
NPI:1487678223
Name:LOUIS MIGLIAZZO D.D.S.,P.C
Entity Type:Organization
Organization Name:LOUIS MIGLIAZZO D.D.S.,P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MIGLIAZZO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:520-323-7550
Mailing Address - Street 1:2544 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-4746
Mailing Address - Country:US
Mailing Address - Phone:520-323-7550
Mailing Address - Fax:520-323-7550
Practice Address - Street 1:2544 E 10TH ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-4746
Practice Address - Country:US
Practice Address - Phone:520-323-7550
Practice Address - Fax:520-323-7550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ35531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty