| NPI | 1396845590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL RAZO Credentialing COO Rdinator 623-434-9343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NV 4949) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2020-08-22 |