| NPI | 1932388188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY PATRICK CARSON Owner/Manager 602-588-7777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: AZ 5467) |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2019-08-22 |