NPI | 1144355470 |
---|---|
Entity Type | Organization |
Authorized Contact | MARGIE D DERRICK Office Manager 520-572-1593 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D4718) |
Enumeration Date | 2007-02-23 |
Last Update Date | 2010-08-24 |