| NPI | 1164813887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUZ PACHECO Human Resource 602-242-5741 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AZ D05236) |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2015-02-17 |