| NPI | 1427230770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT DEE WALLIN Dentist 480-888-2271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 5868) |
| Enumeration Date | 2007-11-28 |
| Last Update Date | 2007-11-28 |