| NPI | 1053525253 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN JAMES WILSON President 602-938-7750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ AZ1826) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2020-08-22 |