| NPI | 1881872554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY K LINES President 623-931-9197 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AZ 3675) |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2008-02-05 |