Individual
EUGENE ERWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3440 E BASELINE RD STE 106, MESA, AZ 85204-7247
(480) 926-2350
Mailing address
839 W CONGRESS ST, TUCSON, AZ 85745-2819
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D011092
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/18/2020
Last updated
07/09/2021
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