| NPI | 1780723197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELBERT LEE KYGER President 520-579-0903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AZ 4690) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2018-05-22 |