NPI | 1194275115 |
---|---|
Doing Business As | ELVIA HERNANDEZ BANUELOS |
Entity Type | Organization |
Authorized Contact | ELVIA HERNANDEZ BANUELOS Dentist 602-774-4309 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: ZZ 2962838) |
Enumeration Date | 2016-10-13 |
Last Update Date | 2016-10-13 |