NPI | 1952488710 |
---|---|
Doing Business As | SCOTT LESUEUR AND CHARLES DODARO DDS |
Entity Type | Organization |
Authorized Contact | SCOTT TAYLOR LESUEUR President 480-834-6991 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: AZ 3434) |
Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: AZ 2695) |
Enumeration Date | 2006-11-01 |
Last Update Date | 2011-02-15 |