| NPI | 1639624463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARA KIMIA President 480-619-1415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 61127) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: CA 61270) |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2023-11-02 |