| NPI | 1255564506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA VITELA Credentialing COO Rdinator 602-482-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AZ 5979) |
| Enumeration Date | 2009-09-02 |
| Last Update Date | 2009-09-02 |