| NPI | 1033288733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT MARK MIRABELLI Pediatric Dentist Practice Owner 602-595-3431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2020-08-22 |