| NPI | 1659308641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH HENEBRY Credentialing COO Rdinator 602-734-4518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: AZ 4411) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2022-04-28 |