| NPI | 1316279201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER HEARNE Regional Director 520-227-0711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: AZ 3413) |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2010-02-03 |