| NPI | 1154622249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE G GROOP Owner/Pres 480-664-1449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D07819) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D08719) |
| Enumeration Date | 2010-11-05 |
| Last Update Date | 2010-11-05 |