| NPI | 1245410232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA M WHITE Manager 623-848-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 3245) |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2007-11-07 |