| NPI | 1942650973 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENUKA PREM KUMAR President 480-767-6918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AZ D03637) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2016-06-21 |