| NPI | 1346451341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLYDE EDWARD MILLER Owner 480-513-2620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D5415) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |