| NPI | 1174048284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLENE MONTES Front Office 480-994-4327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 5754) |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2022-07-21 |