Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | D6044 | AZ |
NPI | 1326082587 |
---|---|
Provider Name | Dr. Eric Roy Engel |
First Address | Chandler, AZ 85226-5940 |
Second Address | Chandler, AZ 85226-5940 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 08/07/2007 |