| NPI | 1780139485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRIS POMMERENING Office Manager 623-561-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 3219) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ 9516) |
| Enumeration Date | 2016-08-23 |
| Last Update Date | 2016-08-23 |