| NPI | 1346650264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA HUISH Front Desk 480-654-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ 6561) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ 8644) |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2014-04-30 |