NPI | 1215320551 |
---|---|
Doing Business As | AVONDALE DENTAL |
Entity Type | Organization |
Authorized Contact | MICHAEL DAVID HUMMITZSCH Owner 623-772-5362 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2015-03-11 |
Last Update Date | 2015-03-13 |