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Individual

DR. NOEL BASCON TIBAJIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
10827 S 51ST ST, SUITE 204, PHOENIX, AZ 85044-1742
(480) 785-9600
(480) 785-9608
Mailing address
10827 S 51ST ST, SUITE 204, PHOENIX, AZ 85044-1742
(480) 785-9600
(480) 785-9608

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4604
AZ

Other

Enumeration date
11/21/2006
Last updated
07/08/2007
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