Provider Demographics
NPI:1912055153
Name:NOSECK & NOSECK, P.C.
Entity Type:Organization
Organization Name:NOSECK & NOSECK, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NOSECK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:520-886-5477
Mailing Address - Street 1:50 N CAMINO SECO
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-2928
Mailing Address - Country:US
Mailing Address - Phone:520-886-5477
Mailing Address - Fax:520-721-8952
Practice Address - Street 1:50 N CAMINO SECO
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-2928
Practice Address - Country:US
Practice Address - Phone:520-886-5477
Practice Address - Fax:520-721-8952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1720261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental