| NPI | 1043466782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE FREEZE Office Manager 928-782-3839 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ d7288) |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2008-08-13 |