| NPI | 1124522297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC SCOTT BJERKE Owner/Dentist 602-412-8648 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 9034) |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2018-03-22 |