| Darryl T. Azouz, D.d.s., Inc. | |
|
1077 4th St South Lake Tahoe CA 96150-3486 | |
| (530) 541-1353 | |
| Not Available |
| Full Name | Darryl T. Azouz, D.d.s., Inc. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1077 4th St, South Lake Tahoe, California |
| Authorized Official Name and Position | Merecedes Figueroa (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 6232893392 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Darryl T. Azouz, D.d.s., Inc. 19601 N Black Canyon Hwy Ste 201 Phoenix AZ 85027-4107 Ph: (623) 289-3392 | Darryl T. Azouz, D.d.s., Inc. 1077 4th St South Lake Tahoe CA 96150-3486 Ph: (530) 541-1353 |
| NPI Number | 1467213918 |
|---|---|
| Provider Enumeration Date | 01/22/2024 |
| Last Update Date | 01/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467213918 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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