Individual
DR. UMAR M IMTIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
23374 W YUMA RD STE 102, BUCKEYE, AZ 85326-3120
(978) 328-2886
(623) 444-6745
Mailing address
23374 W YUMA RD STE 102, BUCKEYE, AZ 85326-3120
(623) 444-9999
(623) 444-6745
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
051498
NY
1223P0221X
Pediatric Dentistry
Primary
7256
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
225122
—
AZ
Enumeration date
06/01/2005
Last updated
07/09/2013
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