| NPI | 1609022805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRAY PATEL Owner 602-954-2177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D7425) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ D6702) |
| 1223E0200X Dentist, Endodontics (Licence: AZ D7048) | |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2008-08-07 |