| NPI | 1649775842 |
|---|---|
| Doing Business As | AGAVE FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | DONNA PERKINS Practice Manager 480-830-0262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2018-03-28 |