| NPI | 1699307306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLETTE BARR Director 480-830-9555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| 251V00000X Voluntary or Charitable | |
| 261Q00000X | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM1000X Clinic/Center, Migrant Health | |
| 261QP0905X Clinic/Center, Public Health, State or Local | |
| 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery | |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2020-02-10 |