| NPI | 1013161157 |
|---|---|
| Other Name | THORNYDALE DENTAL |
| Entity Type | Organization |
| Authorized Contact | CORY SCOTT WERTZ President 520-370-6179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ 5200) |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2008-11-14 |