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 |