NPI | 1619150638 |
---|---|
Entity Type | Organization |
Authorized Contact | STEVEN Q. HANSEN President 623-937-9241 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 2085) |
Enumeration Date | 2007-12-12 |
Last Update Date | 2007-12-12 |