| NPI | 1649785197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHARY XAVIER VAN HILSEN Owner 602-391-8331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: CO DEN.202500) |
| Enumeration Date | 2017-12-06 |
| Last Update Date | 2017-12-06 |