| NPI | 1740673268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLA HOLLEN Owner 520-775-1245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AZ D008688) |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2015-06-03 |