| NPI | 1235530379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN CHARLES SWIGERT Owner 928-201-7786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AZ D008956) |
| Enumeration Date | 2014-09-09 |
| Last Update Date | 2014-09-09 |