| NPI | 1700506326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEN J. HIMMELSTEIN Chief Legal Officer 480-229-7498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-09-01 |
| Last Update Date | 2022-09-01 |