NPI | 1518563139 |
---|---|
Doing Business As | DESERT RIDGE FAMILY DENTAL |
Entity Type | Organization |
Authorized Contact | BENJAMIN L GARDEA Owner/Dentist 520-886-8106 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2020-12-09 |
Last Update Date | 2020-12-09 |