| NPI | 1639381197 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | ANN HAMMI BLUE Periodontist 602-441-4464 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AZ D5379) | 
| Enumeration Date | 2007-05-04 | 
| Last Update Date | 2013-09-23 |