Organization
BAPTIST DENTAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK J HUH D.D.S. (DENTIST / OWNER)
(623) 939-6215
Entity
Organization
Contact information
Practice address
7802 N 43RD AVE STE 8, GLENDALE, AZ 85301-8111
(623) 939-6215
Mailing address
7802 N 43RD AVE STE 8, GLENDALE, AZ 85301-8111
(623) 939-6215
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D04284
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102905
—
AZ
Enumeration date
11/12/2014
Last updated
11/12/2014
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