| NPI | 1497486179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE AYOUB Part Owner 623-536-2040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2022-06-22 |
| Last Update Date | 2022-06-22 |