| NPI | 1154066215 |
|---|---|
| Doing Business As | LEGACY SMILES OF SOUTHERN ARIZONA |
| Entity Type | Organization |
| Authorized Contact | JOB TORRES-GOMEZ Dentist 928-273-1244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-05-03 |
| Last Update Date | 2022-05-15 |