| NPI | 1013038264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE SAVANNAH ALLEN Managing Member 602-242-4745 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: AZ 4952) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-08-22 |