| NPI | 1538358189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK D POGUE President 480-515-5400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: AZ 26467) |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2007-10-19 |