NPI | 1114194651 |
---|---|
Entity Type | Organization |
Authorized Contact | JOE DALE DITTERLINE Dentist Owner 480-661-1200 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D4395) |
Enumeration Date | 2008-05-14 |
Last Update Date | 2008-05-14 |