| NPI | 1093935553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN LUNDGREEN Managing Member 480-830-5003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 210) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2020-08-22 |