| NPI | 1013101419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY MARIE POVAR Managing Member 480-951-6598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: AZ 5585) |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2007-08-29 |