| NPI | 1164754032 |
|---|---|
| Doing Business As | MOUNTAINSIDE FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | ERIC LYNN KERBS President 480-759-4202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ 6458) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ 6458) |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2010-02-03 |