| NPI | 1770628273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY M BECKER Trustee 623-979-9454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 2890) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |