| NPI | 1033325923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE LEE MOORE Owner 928-282-7871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ AZ2205) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2012-01-05 |