| NPI | 1174964530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON LEACH Owner/Dentist 520-722-1182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 357110) |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2013-07-15 |