| NPI | 1679608947 |
|---|---|
| Doing Business As | AGE-DEFYING DENTISTRY, GILBERT |
| Entity Type | Organization |
| Authorized Contact | DAVID JOHN VELASCO Owner 480-545-8400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ AZ3740) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ AZ4044) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2012-08-02 |