| NPI | 1679755060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD B. AHN President 928-855-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: AZ D6409) |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2007-11-28 |
| Last Update Date | 2012-12-13 |