| NPI | 1760755730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT JEFFERSON BUCH Owner 623-792-5794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AZ D8077) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AZ D3178) |
| Enumeration Date | 2012-02-21 |
| Last Update Date | 2012-02-21 |