| NPI | 1467803205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THARON SMITH Managing Orthodontist 520-204-6707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: UT 9637455-9921) |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2016-06-23 |