| NPI | 1649725102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNA BAXTER Periodontist/Owner 480-289-0507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: SC 8638) |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2016-08-24 |