| NPI | 1306071667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN A. LEWIS President 520-490-5743 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OR d9804) |
| Enumeration Date | 2009-05-15 |
| Last Update Date | 2013-01-22 |