| NPI | 1629243571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOYD PATUMMAS Dentist/Vice President 480-820-7777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2024-08-12 |