| NPI | 1487875944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK C PECK Owner 480-488-4852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 3252) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ 6916) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-08-22 |