| NPI | 1871644211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAYLE Y LUNDTVEDT President 520-458-4646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AZ D6233) |
| Enumeration Date | 2007-01-14 |
| Last Update Date | 2013-12-06 |