| NPI | 1679822761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD C. QUINTIA President 520-290-6800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: AZ 3539) |
| Enumeration Date | 2012-09-05 |
| Last Update Date | 2012-09-05 |