| NPI | 1316684236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH BRADSHAW Owner 602-538-7474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2022-05-13 |
| Last Update Date | 2023-03-01 |