| NPI | 1447967492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL HALCOMB Owner 480-398-0206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-10-31 |
| Last Update Date | 2022-11-07 |