| NPI | 1912121930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN K INGERSOLL President 602-953-1744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AZ D2811) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2020-08-22 |