| NPI | 1902250368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL WALKER BOLLWINKEL President 480-892-5089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2016-04-21 |