| NPI | 1952684326 |
|---|---|
| Other Name | SUPERSTITION LAKES DENTAL |
| Entity Type | Organization |
| Authorized Contact | BLAKE G SHREEVE Owner 480-924-5577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2011-11-29 |