| NPI | 1194116475 |
|---|---|
| Doing Business As | WELLNESS DENTAL TATUM/SHEA |
| Entity Type | Organization |
| Authorized Contact | DONGSUK KWAK Authorized Official 602-899-0488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ F000542) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2015-02-09 |
| Last Update Date | 2022-11-14 |