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 |