| NPI | 1568667061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON GREGORY SABOL Owner 602-957-0332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AZ 6816) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AZ 6147) | |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2017-12-28 |