| NPI | 1699833210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW E FORMAN Manager 602-843-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AZ 1625) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2011-01-26 |