NPI | 1740654847 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAELANNE CHADWICK Receptionist 520-575-5576 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: AZ 6203) |
Additional Taxonomies | 122300000X Dentist (Licence: AZ 9026) |
Enumeration Date | 2015-11-30 |
Last Update Date | 2015-11-30 |