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1477177491
ERISA SAM
PHOENIX, AZ
NPI
1477177491
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: AZ D010677)
Enumeration Date
2020-06-05
Last Update Date
2020-06-05
Business Address
ERISA SAM DMD
10720 W INDIAN SCHOOL RD STE 55
PHOENIX, AZ 85037-5724
Phone number: 623-246-7051
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Mailing Address
ERISA SAM DMD
5901 W BEHREND DR APT 1113
GLENDALE, AZ 85308-6941
Phone number: 949-702-2068
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