| NPI | 1316113715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA ANGELES FUENTES Owner 602-841-4400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2013-08-21 |