| NPI | 1952646788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS CERVANTES Clinical Director 602-363-3166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AZ AZ2937) |
| Enumeration Date | 2012-12-05 |
| Last Update Date | 2012-12-05 |