| NPI | 1821851551 |
|---|---|
| Doing Business As | GRANT AND TANQUE VERDE DENTAL |
| Entity Type | Organization |
| Authorized Contact | JEFFREY L ROBERTS Dentist/Partner 602-790-4601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-02-05 |
| Last Update Date | 2024-02-05 |