| NPI | 1629676903 |
|---|---|
| Former Legal Business Name | DENTAL AND BRACES DYSART LLC SOMOSDENTAL |
| Entity Type | Organization |
| Authorized Contact | ELIZABETH RAMOS Credentialing 602-726-3221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-10-09 |
| Last Update Date | 2020-10-09 |