| NPI | 1649685207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE M. KOPSKY Owner 480-563-0069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D04171) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D07598) |
| 1223P0700X Dentist, Prosthodontics (Licence: AZ D04516) | |
| 124Q00000X Dental Hygienist (Licence: AZ D06018) | |
| 124Q00000X Dental Hygienist (Licence: AZ H04081) | |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2014-06-23 |