| NPI | 1558793430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANNON JAY GUNNELL Owner 480-832-5190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ 2564) |
| 122300000X Dentist (Licence: AZ 7577) | |
| 122300000X Dentist (Licence: AZ 7304) | |
| Enumeration Date | 2013-08-02 |
| Last Update Date | 2013-08-02 |