Provider Demographics
NPI:1831357649
Name:RIA FLORES-TAMAYO,D.D.S., INC.
Entity type:Organization
Organization Name:RIA FLORES-TAMAYO,D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OLIVA RIA
Authorized Official - Middle Name:FLORES
Authorized Official - Last Name:TAMAYO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:623-703-4368
Mailing Address - Street 1:14425 W MCDOWELL RD
Mailing Address - Street 2:SUITE F-106
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-2516
Mailing Address - Country:US
Mailing Address - Phone:623-925-8208
Mailing Address - Fax:623-925-8108
Practice Address - Street 1:14425 W MCDOWELL RD
Practice Address - Street 2:SUITE F-106
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-2516
Practice Address - Country:US
Practice Address - Phone:623-925-8208
Practice Address - Fax:623-925-8108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD5502261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental