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 | 1223E0200X Dentist Endodontics |
1223P0221X Dentist Pediatric Dentistry | |
1223P0300X Dentist Periodontics | |
1223P0700X Dentist Prosthodontics | |
Enumeration Date | 2019-03-19 |
Last Update Date | 2019-03-19 |