Provider First Line Business Practice Location Address:
6601 S RURAL RD
Provider Second Line Business Practice Location Address:
SOUTHWEST DENTAL GROUP
Provider Business Practice Location Address City Name:
TEMPE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85283-3747
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-456-0821
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/10/2007