| NPI | 1912588930 |
|---|---|
| Doing Business As | SOUTHWEST PEDIATRIC DENTAL |
| Entity Type | Organization |
| Authorized Contact | CASSANDRA WIETH Director Of Payor Relations 623-267-8121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2021-04-20 |
| Last Update Date | 2026-09-18 |