| NPI | 1043271695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN R. FOULK President 520-744-3480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 3154) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2020-08-22 |