| NPI | 1740532654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER A BASSETT Owner 623-435-2300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ F000453) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: AZ 8328) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AZ 2176) | |
| Enumeration Date | 2012-10-03 |
| Last Update Date | 2012-10-03 |