Organization
LUX DENTAL GROUP OF ARIZONA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY P FULLER DDS (OWNER)
(480) 607-6937
Entity
Organization
Contact information
Practice address
8055 N VIA DE NEGOCIO, SCOTTSDALE, AZ 85258-4313
(480) 607-6937
(480) 607-6973
Mailing address
8055 N VIA DE NEGOCIO, SCOTTSDALE, AZ 85258-4313
(480) 607-6937
(480) 607-6973
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
AZ
Other
Enumeration date
04/14/2015
Last updated
04/14/2015
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