| NPI | 1740484278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN J SHANAHAN Dentist 480-946-0404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 0908190) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2020-08-22 |