| NPI | 1568606507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEENA CHIRIAC Credentialing 800-409-2563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 7705) |
| Enumeration Date | 2009-04-21 |
| Last Update Date | 2009-04-21 |