| NPI | 1659368504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GORDON GENE WILLIAMSON President 623-933-5749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 1290) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2020-08-22 |