| NPI | 1235641937 |
|---|---|
| Doing Business As | CENTRAL PHOENIX CENTER FOR TMJ, PAIN & SLEEP DISORDERS |
| Entity Type | Organization |
| Authorized Contact | STEPHANIE WAGNER KETHCART Managaing Member/Dentist 602-615-8516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AZ D6695) |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2020-07-13 |