| NPI | 1275274722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH BRADSHAW Owner 602-538-7474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2022-04-06 |
| Last Update Date | 2023-05-26 |