| NPI | 1538284971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAROLL ANN GRAZIANO Manager 623-225-6555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D6772) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ D5988) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2009-03-18 |