| NPI | 1316324031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL JOHN KELLY Doctor And Owner 480-258-0879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AZ d6913) |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2015-05-01 |