NPI | 1316602527 |
---|---|
Entity Type | Organization |
Authorized Contact | STACEY C. LAYMAN Dentist / Owner 623-299-8799 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
Enumeration Date | 2021-11-02 |
Last Update Date | 2025-04-01 |