| NPI | 1215460233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIATIK RAMA Manager 623-474-3343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2020-12-08 |