| NPI | 1538275011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY TAYLER HAMMOND President 623-583-1875 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: AZ 6938) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2008-03-14 |