| NPI | 1437500915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED W WELCH Owner 480-917-9339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AZ 5685) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: AZ 8729) |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2016-06-27 |