| NPI | 1619693793 |
|---|---|
| Other Name | DESERT RIDGE ORAL SURGERY INSTITUTE |
| Entity Type | Organization |
| Authorized Contact | VISHTASB N/A BROUMAND Owner 480-284-8087 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2022-10-19 |
| Last Update Date | 2022-10-19 |