| NPI | 1154808749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER VILLANUEVA Doctor 480-494-2001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2018-09-21 |