NPI | 1831589910 |
---|---|
Entity Type | Organization |
Authorized Contact | DOUGLAS ROY GABRIEL Owner/Dentist 623-376-7233 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: AZ DO3749) |
Additional Taxonomies | 122300000X Dentist (Licence: AZ DOO8946) |
124Q00000X Dental Hygienist (Licence: AZ HO2603) | |
Enumeration Date | 2015-01-28 |
Last Update Date | 2015-01-28 |