| NPI | 1023015914 |
|---|---|
| Doing Business As | MONA LISA DENTAL |
| Entity Type | Organization |
| Authorized Contact | CARLOS ALBERTO VALLECILLO President 480-722-7600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 5778) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ 5876) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2020-08-22 |