Provider Demographics
NPI:1295883528
Name:SOUTHERN ARIZONA ENDODONTICS
Entity type:Organization
Organization Name:SOUTHERN ARIZONA ENDODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:I
Authorized Official - Credentials:DDS
Authorized Official - Phone:520-917-2350
Mailing Address - Street 1:1011 N CRAYCROFT RD
Mailing Address - Street 2:STE 107
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-7309
Mailing Address - Country:US
Mailing Address - Phone:520-322-0800
Mailing Address - Fax:
Practice Address - Street 1:1011 N CRAYCROFT RD
Practice Address - Street 2:STE 107
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-7309
Practice Address - Country:US
Practice Address - Phone:520-322-0800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK29991223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty