| NPI | 1477811842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID HAASLO Member 480-833-3330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AZ D5802) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2012-04-24 |