# 1ST DENTAL CARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619236999
- **Authorized official:** MR. LONG K BUI D.D.S. (OWNER)
- **Authorized official phone:** (520) 459-5166

## Contact information

- **Practice address:** 1150 S. HIGHWAY 92,, SUITE A, SIERRA VISTA, AZ 85635
- **Practice address phone:** (520) 459-5166
- **Practice address fax:** (520) 458-8425
- **Mailing address:** 1150 S. HIGHWAY 92,, SUITE A, SIERRA VISTA, AZ 85635
- **Mailing address phone:** (520) 459-5166
- **Mailing address fax:** (520) 458-8425

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D06074 | AZ | — |
| 1223G0001X | General Practice Dentistry | D5764 | AZ | Yes |

## Other

- **Enumeration date:** 05/08/2012
- **Last updated:** 05/08/2012