| NPI | 1558581769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAD D JUSTESEN President 480-839-0985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 2566) |
| Enumeration Date | 2007-04-27 |
| Last Update Date | 2015-06-02 |