| NPI | 1962729806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIGHAM BAKER Dentsit 480-814-8888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AZ 5899) |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2010-05-03 |