| NPI | 1134447113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH LYNN OTT Dentist 623-687-1157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401412745) |
| Enumeration Date | 2010-05-14 |
| Last Update Date | 2010-05-14 |