| NPI | 1750497723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELDON W JENKINS Owner 602-442-7333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D6467) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ D4206) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2020-08-22 |