| NPI | 1023449386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA ZWICKY Credentialing Manager 480-866-8811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AZ D05860) |
| Enumeration Date | 2013-12-11 |
| Last Update Date | 2023-11-14 |