| NPI | 1851857064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENNETT MANKIN CEO 480-636-0170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2019-02-12 |
| Last Update Date | 2020-02-07 |