| NPI | 1023179900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN S CLUFF Owner Hygienist 928-428-2750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 3604) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D1502) |
| 1223G0001X Dentist, General Practice (Licence: AZ 4223) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2020-08-22 |