| NPI | 1063637197 |
|---|---|
| Former Legal Business Name | PETERSEN AND ROLLINS ORTHODONTICS PC |
| Entity Type | Organization |
| Authorized Contact | ARLON M PETERSEN Vice President 480-924-2880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AZ 1961) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AZ 4793) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2020-08-22 |