| NPI | 1689876476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE RIVAS GONZALES President 623-547-0403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AZ D4678) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2020-08-22 |