| NPI | 1356619720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY REED AGNEW President 520-825-1505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 3519) |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2011-12-13 |