| NPI | 1003375965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAU M PHAM President & CEO 480-216-2181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| 1223P0300X Dentist, Periodontics | |
| 1223E0200X Dentist, Endodontics | |
| 1223P0700X Dentist, Prosthodontics | |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2019-03-19 |