| NPI | 1215489141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT MARTINEAU Owner/Dentist 623-975-3933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D6112) |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2016-10-26 |