| NPI | 1598983405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT B TAYLOR Secretary 480-834-6100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 3077) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ 1828) |
| 1223G0001X Dentist, General Practice (Licence: AZ 6165) | |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |