Individual
MR. RAUL FAVELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
301 E BETHANY HOME RD, SUITE A132, PHOENIX, AZ 85012
(602) 277-2333
(602) 274-1080
Mailing address
301 E BETHANY HOME RD, SUITE A132, PHOENIX, AZ 85012
(602) 277-2333
(602) 274-1080
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5541
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
764680
—
AZ
Enumeration date
11/08/2006
Last updated
07/08/2007
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