| NPI | 1568600864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY ANN WILSON Administrator 480-899-4477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 4037) |
| Enumeration Date | 2009-01-26 |
| Last Update Date | 2009-01-26 |