| NPI | 1770005233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHREEDEVI THULASIDAS Owner 480-815-5222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AZ D07677) |
| Enumeration Date | 2017-07-16 |
| Last Update Date | 2022-07-21 |