| NPI | 1194240929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP PLOURDE Dentist / Business Partner 602-615-3269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D009737) |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2022-07-21 |