| NPI | 1184932311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL G SIMPSON Sole Member 623-544-6900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AZ D 8060) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: OH 30.022834) |
| Enumeration Date | 2010-09-22 |
| Last Update Date | 2010-09-22 |