| NPI | 1730378522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY HAMPTON Office Manager 520-663-0419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 5038) |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2013-09-27 |