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 |