| NPI | 1376752808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY JOSEPH SANDVIK Owner Dentist 480-759-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 5676) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-22 |