| 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 |