NPI | 1013121128 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN J. MEHLEM President 602-938-7750 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 1716) |
Enumeration Date | 2007-05-09 |
Last Update Date | 2020-08-22 |