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 |