NPI | 1548482300 |
---|---|
Doing Business As | NORTHERN AVENUE DENTISTRY |
Entity Type | Organization |
Authorized Contact | GORDON D GROSS Owner 602-995-0280 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2007-05-02 |
Last Update Date | 2020-08-22 |