| NPI | 1255175519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH COCHELL Insurance Coordinator 480-924-2369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2024-06-21 |
| Last Update Date | 2024-06-21 |