| NPI | 1043754393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN PRUZANSKY Owner 623-931-4386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AZ 7864) |
| Enumeration Date | 2016-12-06 |
| Last Update Date | 2016-12-06 |