| NPI | 1194247098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL GIBBONS Prosthodontist 480-368-0060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: AZ 2139) |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2022-07-21 |