| NPI | 1083946313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MILLER Technician 623-939-5870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 1004) |
| Enumeration Date | 2010-02-11 |
| Last Update Date | 2010-02-11 |