| NPI | 1619236999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LONG K BUI Owner 520-459-5166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D5764) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D06074) |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2012-05-08 |