| NPI | 1881967610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANDEEP VERMANI Member 602-741-4388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2021-04-01 |