| NPI | 1144509514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY FRYE Office Manager 623-979-7477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 3279) |
| Enumeration Date | 2011-08-16 |
| Last Update Date | 2011-08-16 |