| NPI | 1568635894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN ROBERT PETERSON President 480-325-3368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 5014) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2008-04-08 |