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 |