| NPI | 1851871487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELYN D BUCKHANAN Insurance Coordinator 480-899-7996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D6107) |
| Enumeration Date | 2018-08-14 |
| Last Update Date | 2018-08-14 |