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 |