| NPI | 1588960512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW A. DEFELICE Owner 480-563-3960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AZ 5196) |
| Enumeration Date | 2011-02-09 |
| Last Update Date | 2011-04-04 |