| NPI | 1952514572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA TAEGE Managing Member 480-860-6744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D5941) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2008-10-30 |