| NPI | 1609989748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT PAUL SERRANO Owner/Dds 602-274-7840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AZ D2814) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AZ D5543) |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2010-12-02 |