| NPI | 1639301468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTI ST. ANGE Office Manager 480-314-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AZ 2444) |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2009-08-12 |