| NPI | 1184306136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FORREST PRATT Surgeon And Owner 480-766-9829 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2023-08-01 |
| Last Update Date | 2023-08-01 |