| NPI | 1255757308 |
|---|---|
| Doing Business As | GLENDALE MODERN DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | MARISSA BROWN Owner Doctor 623-939-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2014-03-13 |
| Last Update Date | 2014-03-13 |