| NPI | 1467631812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL D BROADBENT Owner President Dentist 480-924-8633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 3584) |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2007-11-01 |