| NPI | 1841256104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSEY SMITH Office Manager 602-790-2444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D5414) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ D5562) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2020-08-22 |