| NPI | 1376601450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW T FRKETLICH Owner 602-331-7001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 0987) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2020-08-22 |