| NPI | 1003292038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SERGIO G MONTES Dentist 928-445-1660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2015-07-31 |