| NPI | 1124232392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE ANTONIO OSETE President 520-797-4551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: AZ 4364) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2023-05-08 |