| NPI | 1134499007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA MICHELE WOLFMAN Doctor/Owner 520-325-4746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AZ 6632) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: AZ 6742) |
| Enumeration Date | 2012-01-09 |
| Last Update Date | 2013-05-14 |