| NPI | 1104017326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH STANLEY REIDHEAD President 480-839-0366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: AZ 3344) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2007-08-05 |