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1063983245
RUSTIC MOUNTAIN DENTISTRY
TAYLOR, AZ
NPI
1063983245
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Entity Type
Organization
Authorized Contact
KENNETH HOUSTON DAVIS
Doctor/Owner
928-457-0758
Organization Subpart ?
No
Primary Taxonomy
261QD0000X Clinic/Center Dental
Enumeration Date
2018-12-16
Last Update Date
2018-12-16
Business Address
RUSTIC MOUNTAIN DENTISTRY
606 N MAIN STREET
TAYLOR, AZ 85939-8593
Phone number: 928-457-0758
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Mailing Address
RUSTIC MOUNTAIN DENTISTRY
PO BOX 1550
TAYLOR, AZ 85939-1550
Phone number: 928-457-0758
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