| NPI | 1134607641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN SCOTT COOMBS Owner 480-250-4301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AZ AZ5217) |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2018-08-06 |