| 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 |