| NPI | 1063005049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENNETT MANKIN President 480-239-2088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics |
| 1223P0106X Dentist, Oral and Maxillofacial Pathology | |
| Enumeration Date | 2021-02-19 |
| Last Update Date | 2021-02-26 |