| NPI | 1629183397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND A SKINNER Periodontist 602-266-5896 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: AZ 1924) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2020-08-22 |