Provider Demographics
NPI:1568871093
Name:LEWIS, MARIA FATIMA BISQUERA (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARIA FATIMA
Middle Name:BISQUERA
Last Name:LEWIS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:MARIA FATIMA
Other - Middle Name:BARGA
Other - Last Name:BISQUERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:3030 N 67TH PL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6082
Mailing Address - Country:US
Mailing Address - Phone:480-359-3525
Mailing Address - Fax:
Practice Address - Street 1:3030 N 67TH PL
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6082
Practice Address - Country:US
Practice Address - Phone:480-359-3525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-08
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9007122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist