| NPI | 1093315939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA LEIGH ZWICKY Credentialing Manager 480-866-8811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2023-08-22 |