| NPI | 1790886281 |
|---|---|
| Doing Business As | SOUTHERN VISTA DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | ELWYNN CHAD CAFFALL Direct Owner 480-892-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ 6591) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ 2561) |
| 122300000X Dentist (Licence: AZ 6283) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2020-08-22 |