| NPI | 1750986709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELODY BENNION Senior Integrations Specialist 480-234-8490 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-11-30 |
| Last Update Date | 2020-11-30 |