| NPI | 1497058143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN KATHRYN OLES Dentist 602-840-2190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D3823) |
| Enumeration Date | 2010-12-17 |
| Last Update Date | 2010-12-17 |