NPI | 1376200261 |
---|---|
Doing Business As | SURPRISE MODERN DENTISTRY |
Entity Type | Organization |
Authorized Contact | JOSHUA J SHAW Owner 623-777-3329 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2021-11-26 |
Last Update Date | 2021-11-26 |