| NPI | 1932262607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES BRYAN JAKOBSEN Owner 623-772-9600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 6266) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2020-08-22 |