| NPI | 1083799639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANIA MADDY Receptionist 928-774-4400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: AZ 6531) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: AZ 2197) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2017-01-18 |