| NPI | 1689934515 |
|---|---|
| Doing Business As | SHADOW RIDGE DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | SHAUN PATRICK GARDNER Member 480-214-4898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 5603) |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2012-05-25 |