| Dr. Leonard Bafaloukos D.d.s. | |
|
3902 W Camelback Rd Phoenix AZ 85019-5824 | |
| (602) 841-5473 | |
| (602) 841-8640 |
| Full Name | Dr. Leonard Bafaloukos D.d.s. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3902 W Camelback Rd, Phoenix, Arizona |
| Authorized Official Name and Position | Leonard Bafaloukos (OWNER) |
| Authorized Official Contact | 6028415473 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Leonard Bafaloukos D.d.s. 3902 W Camelback Rd Phoenix AZ 85019-5824 Ph: (602) 841-5473 | Dr. Leonard Bafaloukos D.d.s. 3902 W Camelback Rd Phoenix AZ 85019-5824 Ph: (602) 841-5473 |
| NPI Number | 1902000656 |
|---|---|
| Provider Enumeration Date | 06/14/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902000656 | NPI | - | NPPES |
| 803093 | Other | PA | UNITED CONCORDIA |
| AZ0493590 | Other | AZ | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 1523 (Arizona) | Primary |
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