| NPI | 1205258415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAGGIE T LAM Dentist/Owner 480-755-3320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AZ 6178) |
| Enumeration Date | 2014-01-08 |
| Last Update Date | 2014-01-08 |