Provider First Line Business Practice Location Address:
5855 W UTOPIA RD
Provider Second Line Business Practice Location Address:
MIDWESTERN UNIVERSITY DENTAL INSTITUTE
Provider Business Practice Location Address City Name:
GLENDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85308-5251
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
623-806-7070
Provider Business Practice Location Address Fax Number:
623-537-6013
Provider Enumeration Date:
05/17/2006