| NPI | 1780170118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES DUSTIN WEBB Owner 480-295-5253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE60301378) |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2018-07-09 |