| NPI | 1770801656 |
|---|---|
| Doing Business As | AGE-DEFYING DENTISTRY, QC |
| Entity Type | Organization |
| Authorized Contact | DAVID J. VELASCO Owner/Manager 480-545-8400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ AZ3740) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ AZ4044) |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2012-07-17 |