| NPI | 1952555369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY SCOTT CULLIMORE Manager 480-985-2978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 4668) |
| Enumeration Date | 2008-11-12 |
| Last Update Date | 2008-11-12 |