| NPI | 1609474923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIANA RODRIGUEZ Office Manager 520-290-8787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2020-10-09 |
| Last Update Date | 2020-10-09 |