| NPI | 1760845978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER S NELSON Owner 602-938-0880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AZ D009095) |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2016-04-04 |