| NPI | 1083094205 |
|---|---|
| Doing Business As | DENTAL ON CENTRAL TATUM POINT |
| Entity Type | Organization |
| Authorized Contact | HOLLY MARIE KOZERSKI Practice Administrator 602-266-1776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D6700) |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2015-06-03 |