| NPI | 1174770085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOLOMON TEKLE WOLDESILASSIE President 480-563-4173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 5068) |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2008-08-21 |