NPI | 1831217132 |
---|---|
Entity Type | Organization |
Authorized Contact | PAUL A. LINES President 480-968-3848 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AZ az1556 and az2288) |
Enumeration Date | 2007-03-26 |
Last Update Date | 2020-08-22 |