Provider Demographics
NPI:1508024316
Name:LUGAY, ANTONIO G JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:G
Last Name:LUGAY
Suffix:JR
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 1:7835 E GELDING DR
Mailing Address - Street 2:SUITE F
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2996
Mailing Address - Country:US
Mailing Address - Phone:480-315-9140
Mailing Address - Fax:480-348-5824
Practice Address - Street 1:7835 E GELDING DR
Practice Address - Street 2:SUITE F
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2996
Practice Address - Country:US
Practice Address - Phone:480-315-9140
Practice Address - Fax:480-348-5824
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ49831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ18057OtherUNITED CONCORDIA