| NPI | 1235348830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS GORDON President 623-362-8200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AZ 2191) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2020-08-22 |