| NPI | 1477921385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTOPHER KNIGHT Regional Manager 602-269-7797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 122300000X Dentist | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2018-04-11 |