| NPI | 1265618243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEN S BUI Dentist/Owner 623-930-0060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D6674) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ D6675) |
| Enumeration Date | 2008-01-21 |
| Last Update Date | 2008-01-22 |