| NPI | 1740596717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC LYNN KERBS Director 480-648-4037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 6458) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ 6458) |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2013-12-06 |