| NPI | 1154796050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD SCOTT CONNELL Doctor 480-839-7996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D06107) |
| Enumeration Date | 2015-12-03 |
| Last Update Date | 2015-12-03 |