| NPI | 1063577393 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | BETH D VANDER SCHAAF President 480-994-5225  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 4426)  | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ 4398)  | 
| Enumeration Date | 2006-12-27 | 
| Last Update Date | 2020-08-22 |