NPI | 1255695813 |
---|---|
Entity Type | Organization |
Authorized Contact | PETER SPILOTRO Owner/President 623-680-9911 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: AZ D5123) |
Additional Taxonomies | 122300000X Dentist (Licence: AZ D4664) |
1223E0200X Dentist, Endodontics (Licence: AZ D5915) | |
Enumeration Date | 2012-06-28 |
Last Update Date | 2012-06-28 |