| NPI | 1417445099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN PETER COOPERMAN Owner 480-324-6457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: AZ 9640) |
| Enumeration Date | 2018-04-29 |
| Last Update Date | 2018-04-29 |