| NPI | 1912038076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED POPE Owner 520-568-9100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 5625) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ 5769) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2011-11-16 |