NPI | 1518105691 |
---|---|
Entity Type | Organization |
Authorized Contact | RUSSELL W. RODERICK Doctor 480-515-0404 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 4906) |
Enumeration Date | 2009-01-28 |
Last Update Date | 2009-01-28 |