NPI | 1851094528 |
---|---|
Entity Type | Organization |
Authorized Contact | BOBBY YASSO Dentist 602-613-8004 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Additional Taxonomies | 1223G0001X Dentist, General Practice |
Enumeration Date | 2023-03-22 |
Last Update Date | 2023-04-11 |